Article Text
Abstract
Introduction Atherosclerotic Cardiovascular Disease (ASCVD) remains a leading cause of global cardiovascular mortality, responsible for 80% of related deaths. Lowering low-density lipoprotein cholesterol (LDL-C) is crucial in mitigating atherosclerotic plaque progression and reducing ASCVD incidence.
Objective The primary objective of this study is to assess the effectiveness of the Cardiovascular Risk Reduction Clinic (CRRC) at Hospital Pulau Pinang in achieving risk-based LDL-C targets in patients receiving LDL-C-lowering therapy (LLT) at baseline, 6 months, and 12 months. The secondary aim is to analyse patterns of LLT utilization, along with patient demographics, education, and lifestyle interventions.
Materials and Method This single-arm observational study utilized medical records of adults aged 18 and above with established ASCVD or ASCVD-risk equivalents and LDL-C levels >1.8 mmol/L. Statistical analyses included McNemar Test for assessing LDL-C goal achievement. Absolute and percentage reductions in LDL-C were assessed through Paired T-tests and One-sample T-tests, respectively, with statistical significance defined at P < 0.05.
Results Data were collected from 70 patients (mean age 57.5, SD 11.0), predominantly male (86%), Malay (41%), and Chinese (39%). All patients had ASCVD history, with 67% undergoing cardiac surgery/intervention and 71% having multivessel disease. Common comorbidities included hypertension (74%) and diabetes (36%), while 11% of patients experienced premature ASCVD (first event <40 years old). Follow-up data were available for 60 and 56 patients at 6 and 12 months, respectively. Significant reductions in mean LDL-C levels were observed at month 6 (−1.8 mmol/L, 44.6%, p < 0.0001) and month 12 (−1.8 mmol/L, 46.7%, p < 0.0001). Achievement of LDL-C <1.8 mmol/L was noted in 53.3% (month 6) and 55.4% (month 12), with similar trends for LDL-C <1.4 mmol/L (26.7% at month 6, 30.4% at month 12). Combination lipid-lowering therapy utilization increased significantly from baseline to 71.4% at month 6 and 80.7% at month 12, demonstrating significant progress in cardiovascular risk management.
Conclusion The CRRC at Hospital Pulau Pinang effectively reduced LDL-C levels over 12 months, demonstrating its role in managing cardiovascular risk through optimized therapy and patient education. Longer-term studies with larger cohorts are warranted to further validate these findings.