Guidelines Oriented Approach to Lipid Lowering (GOAL) in Canada

Guidelines Oriented Approach to Lipid Lowering (GOAL) in Canada

Cross-sectional observational study designed to identify and describe the care gap in guideline-oriented low density lipoprotein cholesterol (LDL-C) management in Canadian patients at high cardiovascular risk.

This is a cross-sectional observational study designed to provide real-life data on the current management of dyslipidemia in high cardiovascular risk patients in routine clinical practice. Canadian guidelines recommend a target for LDL-C of ≤2.0 mmol/L (or ≥50% decrease) after treatment initiation in high-risk patients. The recommended first line treatment is statin therapy. Available data clearly indicates that up to 50% of high risk patients do not achieve this important target because of statin inadequacy or intolerance leading to non-adherence.

Therefore this program aims to provide further insights into the challenges Canadian physicians face in helping their high risk patients achieve guideline-recommended LDL-C.

Inclusion Criteria:

1. Adults ≥ 18 years old 2. High risk for cardiovascular morbidity and mortality (at least one of the following):

1. Clinical vascular disease:

   • Coronary Artery Disease (CAD): history of myocardial infarction (MI), Coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), angiographic disease
   • Cerebrovascular Disease (CeVD): history of cerebrovascular accident (CVA) or transient ischemic attack (TIA), carotid surgery
   • Abdominal Aortic Aneurism (AAA): history of surgery/intervention
   • Peripheral Arterial Disease (PAD): history of surgery/intervention

2. Familial hypercholesterolemia defined as LDL-C > 5 mmol/L and one of:

   • typical physical findings (stigmata) such as tendon xanthomata, xanthelasma, and arcus corneae
   • personal history of early cardiovascular disease
   • family history of early cardiovascular disease or of marked hyperlipidemia

3. Receiving current optimal (maximal or maximal tolerated) statin therapy for at least 3 months prior to patient enrolment

4. LDL-C > 2.0 mmol/L measured within 6 months of patient enrolment date and while on (despite) maximal tolerated statin therapy (± other lipid modifying therapies).

5. Desire and ability to execute the consent to participate.

Exclusion criteria:

1. Current treatment with PCSK9 inhibitor
2. Participation in an investigational study
3. Prior participation in the GOAL program