Background and Aims: In Egypt, some studies, including the CardioRisk and
CEPHEUS, highlight the prevalence of dyslipidemia and the suboptimal
achievement of LDL-C therapeutic targets. As PCSK-9 based therapies emerging,
evaluating current practices and goal attainment in lipid-lowering therapy in
Egypt is crucial.
Methods: This observational cross-sectional study investigated lipid-lowering
therapy (LLT) usage in primary and secondary cardiovascular prevention across
Egypt. Patients, aged 18 or above and on stable LLT for at least 2 months, were
enrolled during routine clinic visits. Data was collected via an electronic case
report form (eCRF). The study aimed to understand the prescription patterns and
LLT's role in achieving LDL-C goals as per the 2019 ESC/EAS guidelines, focusing
on patients with stabilized LLT.
Results: In the period from September 2022 to October 2023, we enrolled 702
patients in the phase-I of the study (mean age 6011 years, 47% females). Fifty
one percent were taking LLT for primary prevention, and 49% for secondary
prevention. Ninety nine percent of the total population were on statins (53%
high-intensity, 46% moderate-intensity, and 0.4% low-intensity statins). Generic
forms of statins were used in 64% of cases. Combination therapy with Ezetimibe
was used in 45% of cases. Only 1.1% of cases were on PCSK-9 based therapy (all
of them were receiving monoclonal antibodies). Regression analysis showed that
old age, female gender, and low CV risk category were significant independent
predictors for not using high-intensity statins. According to 2019 ESC guidelines,
percentages of patients achieving their risk-based goals were 28%, 37%, 71%,
and 41% in the very high-risk, high-risk, moderate-risk, and low risk categories
respectively.
Conclusions: Egyptian clinical practices still don't fully align with guidelines for
managing cholesterol. There's a need for increased use of non-statin lipidlowering
treatments, even alongside optimized statin therapy |
