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BEAT Survey Study

Understanding the Lipid Management in Primary & Secondary Prevention

Doctor’s details
Years of clinical practice*

Predominant type of practice*

    Lipid management in primary prevention setting
  1. In your clinical practice, every day how many patients do you see with dyslipidaemia?*

  2. Which of the following are risk factors that might prompt you to screen for dyslipidaemia?*

  3. In your patient over 40 years – for which Risk Factors would you start statin irrespective of baseline LDL-levels*

  4. When do you recommend Lipid profile test to your patients? *

  5. What is the frequency of lipid profile testing recommended by you in your clinical practice in primary prevention setting?*

  6. Do you set LDL-C targets for each of your patients?*

  7. Considering the higher CV mortality in India, should cholesterol level threshold to initiate treatment be lower than western counterparts?*

  8. What are the approaches followed by you to identify the intensity of statin therapy?*

  9. what are the challenges for not up-titrating statin doses?*

  10. At what lipid levels do you initiate lipid lowering therapy in patients with following risk factors*
    11. Risk Factors LDL-C levels (mg/dl)
    <100 100-149 150-199 >200
    Age ≥ 45
    BMI ≥ 25kg/m2
    Hypertension
    Dyslipidaemia
    Family history of ASCVD in a first-degree relative
    Smoking
  11. Kindly mark your therapeutic preference in specific dyslipidaemia Profiles

    12. In your practice what is your preference of using lipid lowering agent in primary prevention for following patient profile. (Please rank from 1 -4 with 1 being most and 4 as least)*

    a. Type 2 diabetes with atherogenic dyslipidaemia (LDL > 160 mg/dl, TG-200-499 mg/dl, HDL< 40 mg/dl without CHD or CHD risk equivalents)
    Lipid Lowering agents Rank 1-4
    Statin alone
    Fibrates
    Statin + Fibrate
    Statin + Ezetimibe
    b. Moderate Hypertriglyceridemia (TG-200-499 mg/DL and LDL at goal)
    Lipid Lowering agents Rank 1-4
    Statin alone
    Fibrates alone
    Statin + Fibrate
    Statin + Ezetimibe
    c. Patients with borderline high LDL level (LDL- 130-160 mg/dl normal TG < 200 mg/dl, without CHD risk equivalents)
    Lipid Lowering agents Rank 1-4
    Statin alone
    Ezetimibe alone
    Statin + Fibrate
    Statin + Ezetimibe
    d. Young patients with LDL level between 160 to 200 mg/dl normal TG < 200 mg/dl, with risks of smoking and obesity)
    Lipid Lowering agents Rank 1-4
    Statin alone
    Ezetimibe alone
    Statin + Fibrate
    Statin + Ezetimibe
  12. What percentage of your patients on statins reach target goals of LDL?*

  13. Which strategy would you prefer in patients on statin and not at LDL-C goals *

  14. What percentage of patients do not tolerate statin in your practice?*

  15. Which are the most commonly observed adverse events with statin use in your practice?*

  16. What are your preferred approaches for management of statin intolerance?*

  17. Which of the following agents most commonly found to cause myalgia?*

  18. In what percentage of your patients do you routinely evaluate renal function for your patient with established ASCVD?*

  19. In primary prevention for persons over age 40 with CKD but not on dialysis do you prefer to initiate statin / statin + ezetimibe?*

  20. What % of patients are non-compliant to statins ?*

  21. With positive results from “Evaluation of Major Cardiovascular events in patients with or at high risk for Cardiovascular Disease who are statin intolerant treated with Bempedoic Acid or Placebo” (CLEAR Outcome) – would you add Bempedoic acid to statin therapy for more patients*

  22. In elderly CKD patient with diabetes, which of the following will be your statin of choice with strength*

  23. In your practise in adult patients with diabetes and proteinuria, and taking stable dose of RAAS inhibitors, which of the following statin do you prefer*

  24. In which of the following factors you consider while choosing combination of Aspirin with statin (Choose more than 1 if applicable)*

  25. What percentage of your primary prevention patients do you prefer statin +Aspirin combination*
    26. Statin
    %
    Statin+Aspirin
    %

    Total

    		 100%
  26. Would you consider prescribing FDC of low dose statin plus bempedoic acid in patients not achieving target LDLc levels in primary prevention?*

  27. If yes, which combination of statin and bempedoic acid would you prefer in your clinical practice ?*

  28. Do you recommend testing for hsCRP for identification of additional risk?*

  29. If yes, then which type of patient do you recommend hsCRP testing (tick more than one if applicable)*

    30. Lipid management in secondary prevention setting
  30. What percentage of established/documented ASCVD patients do you see in your practice?*

  31. In your established ASCVD patients, what is the LDL goal you want your patients to achieve ?*

  32. In order to reach LDL goals, which approach do you prefer?*

  33. In your secondary prevention patients,for how long do on an average you recommend high intensity statin?*

  34. Which is your preferred statin post-ACS – first 3 months? (Please specify dose used for the statin selected)*

    		35.
    mg

    mg

    mg

  35. Which is your preferred statin post-ACS – 3-6 months? (Please specify dose used for the statin selected)*

    		36.
    mg

    mg

    mg

  36. In what % of your secondary prevention do you prefer?*
    37. Statin alone
    %
    Fixed dose combination of Statin + Aspirin
    %
    Fixed dose combination Statin + Aspirin + Clopidogrel
    %

    Total

    		 100%
  37. Despite high intensity statin therapy what percentage of your patients continue to have high LDL levels in secondary prevention?*

  38. In what percentage of high-risk patients, you will initiate following along with high-intensity statin if LDL C is above target*
    39. Bempedoic Acid
    %
    PCSK9i
    %

    Total

    		 100%
  39. What percentage of your patients present with the risk of bleeding?*

  40. Which antiplatelet agents do you commonly prescribe along with statin for secondary prevention (either FDC or single agent)?*

  41. To which patient profile will you prefer to add SAPT + Statin?*