Guidelines Oriented Approach to Lipid Lowering (GOAL) in Canada

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

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

• 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
• 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
• Receiving current optimal (maximal or maximal tolerated) statin therapy for at least 3 months prior to patient enrolment
• 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).
• Desire and ability to execute the consent to participate.

Exclusion criteria

• Current treatment with PCSK9 inhibitor
• Participation in an investigational study
• Prior participation in the GOAL program