Kausik K. Ray (United Kingdom)
Imperial College London Department of Primary Care and Public HealthAuthor Of 24 Presentations
Panel discussion (ID 1559)
Introduction (ID 1518)
Live Q&A (ID 1386)
Treating to Risk- Beyond LDL-C in decision making for LDL-C lowering (ID 1538)
Case study related to ‘Are the ESC/EAS LLT pathways fit for everyday practice – new insights from the DA VINCI and HEYMANS studies’ (ID 1564)
Conclusion (ID 1520)
Prevention at a population level-putting theory into practice (ID 1389)
Two cases of discussion regarding typical but difficult to treat patients at varying levels of CV risk (ID 1539)
Q&A (ID 1496)
Welcome by EAS president (ID 1591)
Introduction (ID 1526)
Live Q&A (ID 1390)
Live Q&A (ID 1551)
Introduction (ID 1497)
Young Investigator Awardees (ID 1601)
Overcoming barriers to population health-through siRNA based therapies (ID 1530)
Roundtable Speakers (ID 1391)
Are the ESC/EAS LLT pathways fit for everyday practice – new insights from the DA VINCI and HEYMANS studies (ID 1555)
Introduction (ID 1515)
Live Q&A (ID 1382)
Introduction (ID 1622)
Opening remarks - Objectives of Symposium (ID 1535)
O060 - Evolocumab use and LDL-C lowering in a cohort of European patients with familial hypercholesterolemia (FH) - results from the HEYMANS study (ID 1422)
Abstract
Background and Aims
Describe real-world evolocumab use in FH patients.
Methods
This prospective observational cohort study enrolled adults ≥18 years old initiating evolocumab across 12 European countries from August 2015. The objectives were to describe clinical characteristics and LDL-C control among patients initiating evolocumab. We report data from patients with FH and follow up until July 2020.
Results
Of 1952 patients enrolled in HEYMANS, 766 (39%) had heterozygous (He) and 35 (1.8%) had homozygous (Ho) FH. Main diagnostic methods: Dutch lipid clinic network (40%), genetic testing (32%), LDL-C (19%). Mean age of FH patients, 57.2 (95% CI, 56.4-57.9) years; 56% male. Three-quarters (74%) of FH patients had additional comorbidities: hypertension, 55%; diabetes, 14%; chronic kidney disease stage ≥2, 5%; current/former smoker, 46%; body mass index ≥ 30, 22%. At evolocumab initiation, 45% of patients in the HeFH group were not receiving statins, 43% not receiving ezetimibe, 34% receiving high intensity statin+ezetimibe. Median (IQR) LDL-C in the HeFH group was 4.30 (3.39, 5.51) mmol/L at evolocumab initiation and dropped by 57% within 3 months; this reduction was maintained for up to 24 months (Figure 1). 55% of HeFH patients achieved an LDL-C <1.4 mmol/L following evolocumab initiation.
Conclusions
In this large study of European clinical practice, a large proportion of HeFH patients initiating evolocumab were not receiving statins and had LDL-C above 4 mmol/L, despite meeting the ESC/EAS definition of very high CV risk. Following evolocumab initiation, median LDL-C fell by over half and this reduction maintained for up to 24 months.
O064 - Are risk-based LDL-C goals achieved in primary and secondary care in Central and Eastern Europe? Comparison with other Europe regions from the DA VINCI observational study (ID 1412)
Abstract
Background and Aims
Assess the proportion of patients in the Central and Eastern Europe (CEE) region achieving the risk-based LDL-C goals recommended by the 2016 and 2019 ESC/EAS guidelines. Compare with other Europe regions.
Methods
Data were collected at a single visit for adults who consented to participate, with any LLT in the past 12 months and an LDL-C measurement in the past 14 months. Primary outcome was LDL-C goal attainment ≥ 28 days after starting the most recent lipid lowering therapy (stabilized LLT).
Results
Out of 5888 total subjects, 2154 were enrolled from six CEE countries: Czech Republic, n=509; Hungary, n=319; Poland, n=460; Romania, n=259; Slovakia, n=123; Ukraine, n=484. Mean (SD) age, 64 (11) years; 48% female. Of 1476 subjects on stabilized LLT at LDL-C measurement, 664 (45%) were primary prevention and 812 (55%) secondary prevention. 53% were receiving moderate intensity statin monotherapy; 32% receiving high intensity statin monotherapy and 5% receiving ezetimibe combination therapy. Mean (SD) LDL-C was 97 mg/dL (2.5 mmol/L). 44% and 24% of patients achieved their risk-based LDL-C 2016 and 2019 goals, respectively. Goal attainment in the CEE region was lower than observed in Northern and Western Europe (Figure 1).
Conclusions
These data highlight a significant gap between guidelines and clinical practice for lipid management in the CEE region, with fewer than one-quarter of patients having LDL-C levels below the 2019 risk-based LDL-C goal. Risk-based goal attainment was lower than observed in Northern or Western Europe; combination therapy with non-statin LLT is needed to address this gap.
Presenter of 23 Presentations
Case study related to ‘Are the ESC/EAS LLT pathways fit for everyday practice – new insights from the DA VINCI and HEYMANS studies’ (ID 1564)
Conclusion (ID 1520)
Live Q&A (ID 1386)
Two cases of discussion regarding typical but difficult to treat patients at varying levels of CV risk (ID 1539)
Q&A (ID 1496)
Welcome by EAS president (ID 1591)
Introduction (ID 1526)
Prevention at a population level-putting theory into practice (ID 1389)
Live Q&A (ID 1551)
Introduction (ID 1497)
Young Investigator Awardees (ID 1601)
Overcoming barriers to population health-through siRNA based therapies (ID 1530)
Live Q&A (ID 1390)
Are the ESC/EAS LLT pathways fit for everyday practice – new insights from the DA VINCI and HEYMANS studies (ID 1555)
Introduction (ID 1515)
Introduction (ID 1622)
Opening remarks - Objectives of Symposium (ID 1535)
Roundtable Speakers (ID 1391)
Panel discussion (ID 1559)
Introduction (ID 1518)
Live Q&A (ID 1382)
Treating to Risk- Beyond LDL-C in decision making for LDL-C lowering (ID 1538)
O060 - Evolocumab use and LDL-C lowering in a cohort of European patients with familial hypercholesterolemia (FH) - results from the HEYMANS study (ID 1422)
Abstract
Background and Aims
Describe real-world evolocumab use in FH patients.
Methods
This prospective observational cohort study enrolled adults ≥18 years old initiating evolocumab across 12 European countries from August 2015. The objectives were to describe clinical characteristics and LDL-C control among patients initiating evolocumab. We report data from patients with FH and follow up until July 2020.
Results
Of 1952 patients enrolled in HEYMANS, 766 (39%) had heterozygous (He) and 35 (1.8%) had homozygous (Ho) FH. Main diagnostic methods: Dutch lipid clinic network (40%), genetic testing (32%), LDL-C (19%). Mean age of FH patients, 57.2 (95% CI, 56.4-57.9) years; 56% male. Three-quarters (74%) of FH patients had additional comorbidities: hypertension, 55%; diabetes, 14%; chronic kidney disease stage ≥2, 5%; current/former smoker, 46%; body mass index ≥ 30, 22%. At evolocumab initiation, 45% of patients in the HeFH group were not receiving statins, 43% not receiving ezetimibe, 34% receiving high intensity statin+ezetimibe. Median (IQR) LDL-C in the HeFH group was 4.30 (3.39, 5.51) mmol/L at evolocumab initiation and dropped by 57% within 3 months; this reduction was maintained for up to 24 months (Figure 1). 55% of HeFH patients achieved an LDL-C <1.4 mmol/L following evolocumab initiation.
Conclusions
In this large study of European clinical practice, a large proportion of HeFH patients initiating evolocumab were not receiving statins and had LDL-C above 4 mmol/L, despite meeting the ESC/EAS definition of very high CV risk. Following evolocumab initiation, median LDL-C fell by over half and this reduction maintained for up to 24 months.