{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T14:10:46Z","timestamp":1758636646474,"version":"3.40.5"},"reference-count":18,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,5,18]],"date-time":"2021-05-18T00:00:00Z","timestamp":1621296000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009857","name":"Regeneron Pharmaceuticals","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009857","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004339","name":"Sanofi","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004339","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Non\u2010statin lipid lowering therapies (LLTs) provide additional treatment options for patients. Use patterns and patient perceptions of non\u2010statin LLT remain incompletely described.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>The guideline\u2010recommended statin intensity remains underutilized in patients treated with and without non\u2010statin LLT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The PALM Registry collected LLT information on patients with or at risk of ASCVD treated at 125 US clinics in 2015. We compared patient perceptions, lipid levels and statin use among patients treated with and without non\u2010statin LLT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 7720 patients, 1930 (25.0%) were treated with a non\u2010statin LLT (1249 fish oil, 417 fibrates, 329 ezetimibe, 196 niacin). Concurrent statin treatment occurred in 73.7%, of which 45.4% were dosed under the guideline\u2010recommended intensity. Compared with patients on statin alone, patients receiving both a statin and non\u2010statin LLT (<jats:italic>n<\/jats:italic>\u00a0=\u00a01423) were more likely to be male, white race and to perceive themselves as higher risk of ASCVD compared with their peers (38.5% vs. 34.9%, p\u00a0=\u00a0.047). Only 27.4% of patients treated with non\u2010statin LLT alone perceived themselves at higher risk. Most (75.7%) patients treated with a non\u2010statin LLT alone reported never being treated with a statin, despite ASCVD in 30.8% of these patients. Among those previously treated with a statin, 59.3% reported being willing to try a statin again.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Non\u2010statin LLT is used in one in four patients with or at risk for ASCVD; its use is frequently in place of statin therapy or in the absence of guideline\u2010recommended statin intensity. More work is needed to establish statins as first line therapy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.23625","type":"journal-article","created":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T05:02:00Z","timestamp":1621400520000},"page":"863-870","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Patient perceptions and use of <scp>non\u2010statin<\/scp> lipid lowering therapy among patients with or at risk for atherosclerotic cardiovascular disease: Insights from the <scp>PALM<\/scp> registry"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2626-9238","authenticated-orcid":false,"given":"Angela","family":"Lowenstern","sequence":"first","affiliation":[{"name":"Duke Clinical Research Institute  Durham North Carolina USA"},{"name":"Division of Cardiology, Department of Medicine Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuang","family":"Li","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute  Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6197-9860","authenticated-orcid":false,"given":"Ann Marie","family":"Navar","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute  Durham North Carolina USA"},{"name":"Division of Cardiology, Department of Medicine Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9541-6954","authenticated-orcid":false,"given":"Salim S.","family":"Virani","sequence":"additional","affiliation":[{"name":"Department of Medicine Baylor College of Medicine  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veronique L.","family":"Roger","sequence":"additional","affiliation":[{"name":"Department of Health Sciences Research and Department of Cardiovascular Diseases Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer G.","family":"Robinson","sequence":"additional","affiliation":[{"name":"Department of internal medicine University of Iowa  Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne C.","family":"Goldberg","sequence":"additional","affiliation":[{"name":"Department of internal medicine, division of endocrinology Washington University  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wendy","family":"Kampman","sequence":"additional","affiliation":[{"name":"Medical affairs Regeneron Pharmaceuticals, Inc.  Tarrytown New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric D.","family":"Peterson","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute  Durham North Carolina USA"},{"name":"Division of Cardiology, Department of Medicine Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracy Y.","family":"Wang","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute  Durham North Carolina USA"},{"name":"Division of Cardiology, Department of Medicine Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,5,18]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.08.042"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000437738.63853.7a"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1410489"},{"key":"e_1_2_8_5_1","first-page":"CIR000000000000","article-title":"AHA\/ACC\/AACVPR\/AAPA\/ABC\/ACPM\/ADA\/AGS\/APhA\/ASPC\/NLA\/PCNA guideline on the Management of Blood Cholesterol","volume":"2018","author":"Grundy SM","year":"2018","journal-title":"Circulation"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2015.08.002"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2017.08.005"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.011765"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2012.02.016"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2004.02.060"},{"key":"e_1_2_8_11_1","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.jacc.2016.03.519","article-title":"2016 ACC expert consensus decision pathway on the role of non\u2010statin therapies for LDL\u2010cholesterol lowering in the Management of Atherosclerotic Cardiovascular Disease Risk: a report of the American College of Cardiology Task Force on clinical expert consensus documents","volume":"68","author":"Writing C","year":"2016","journal-title":"J Am Coll Cardiol"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1812792"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2019.04.027"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1300955"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1107579"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1001282"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.014347"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1734-1140(11)70601-6"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.624890"}],"container-title":["Clinical Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clc.23625","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/clc.23625","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clc.23625","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T06:45:42Z","timestamp":1693291542000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/clc.23625"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,18]]},"references-count":18,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,6]]}},"alternative-id":["10.1002\/clc.23625"],"URL":"https:\/\/doi.org\/10.1002\/clc.23625","archive":["Portico"],"relation":{},"ISSN":["0160-9289","1932-8737"],"issn-type":[{"type":"print","value":"0160-9289"},{"type":"electronic","value":"1932-8737"}],"subject":[],"published":{"date-parts":[[2021,5,18]]},"assertion":[{"value":"2021-03-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-04-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}