{
  "abstract": "Introduction Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of morbidity and mortality globally, and lowering low-density lipoprotein cholesterol (LDL-C) is a key strategy in primary prevention. 1 The National Institute for Health and Care Excellence (NICE) guidelines recommend achieving a reduction in non-high-density lipoprotein (non-HDL) cholesterol of greater than 40% for primary prevention of cardiovascular events.2 However, many patients, particularly those with statin intolerance, struggle to reach this target using statins alone. Bempedoic acid, a non-statin oral therapy, has been shown to significantly reduce LDL-C and non-HDL cholesterol.1 3 This retrospective analysis evaluates the effectiveness of bempedoic acid in meeting NICE targets for non-HDL cholesterol reduction in primary prevention patients.Purpose To assess the effectiveness of bempedoic acid in achieving NICE targets for non-HDL cholesterol reduction (greater than 40%) in primary prevention patients, particularly those with statin intolerance.Methods This retrospective cohort included 721 patients who were prescribed bempedoic acid as part of combination therapy for primary prevention of ASCVD. Baseline characteristics included a mean age of 69.2 years (SD 10.2), with 53% female and 47% male patients; 94% British or Mixed British ethnicity. The baseline LDL-C was 2.83 mmol/L (SD 1.08), and non-HDL cholesterol was 3.71 mmol/L (SD 1.16). Sequential measurements were taken at follow-up up to 311 days. The primary outcome was the reduction in non-HDL cholesterol of greater than 40%, in line with NICE guidelines.Results LDL-C and Non-HDL Cholesterol Reduction:At baseline, LDL-C was 2.83 mmol/L, which decreased to 1.92 mmol/L, 1.80 mmol/L, and 1.71 mmol/L across sequential follow-up intervals. Non-HDL cholesterol showed a significant reduction, from 3.71 mmol/L at baseline to 2.73 mmol/L, 2.60 mmol/L, 2.51 mmol/L, and 2.30 mmol/L at subsequent intervals, meeting the NICE target of a greater than 40% reduction in non-HDL cholesterol in 58% of patients.Adherence and Persistence:Adherence to therapy was 90.7%, with approximately 85% of patients remaining on therapy. Discontinuation occurred in 114 patients (15.8%), typically due to non-specific symptoms, with most transitioning to ezetimibe monotherapy.Statin Intolerance:Despite statin intolerance in some patients, bempedoic acid allowed for substantial LDL-C and non-HDL cholesterol reductions, achieving the NICE target of a 40% reduction in non-HDL cholesterol in a significant portion of patients.Discussion This retrospective analysis demonstrates that bempedoic acid is effective in achieving NICE targets for non-HDL cholesterol reduction in primary prevention patients, including those with statin intolerance. The majority (58%) of patients achieved the NICE target of a greater than 40% reduction in non-HDL cholesterol, confirming the potential of bempedoic acid as a viable therapy for achieving primary prevention goals. While statin intolerance is a barrier to LDL-C reduction in many patients, bempedoic acid provides an alternative that enables patients to meet NICE cholesterol targets, suggesting its critical role in lipid management in primary prevention settings. 1 3Conclusion Bempedoic acid offers an effective solution for patients with statin intolerance in primary prevention by significantly reducing both LDL-C and non-HDL cholesterol, helping patients achieve the NICE target of a greater than 40% reduction in non-HDL cholesterol. 2 3 This real-world data supports the use of bempedoic acid as a key therapy for primary prevention, particularly in patients who cannot tolerate statins. The findings highlight the need for combination therapies, such as bempedoic acid, to optimize lipid management and achieve NICE targets in primary prevention of cardiovascular disease.",
  "authors": [
    {
      "affiliations": [
        "Marsh Medical Practice, Louth, United Kingdom"
      ],
      "name": "Carl Deaney"
    },
    {
      "affiliations": [
        "Marsh Medical Practice, Louth, United Kingdom"
      ],
      "name": "Meredith Donaldson"
    }
  ],
  "title": "292 The role of bempedoic acid in primary prevention of ASCVD: a real-world evaluation of LDL-C and Non-HDL cholesterol reduction in rural primary care",
  "uid": "41914ff3-62c5-5913-995f-c492fff9ba74"
}