Rosuvastatin use in contemporary clinical practice: insights from a physician survey on lipid management and cardiovascular risk reduction

Abstract

Background: Contemporary lipid management guidelines advocate increasingly stringent low-density lipoprotein cholesterol (LDL-C) targets and earlier treatment intensification in patients at elevated cardiovascular risk. Rosuvastatin remains a widely prescribed statin owing to its potent LDL-C-lowering efficacy; however, real-world prescribing practices and treatment preferences continue to evolve with expanding use of combination lipid-lowering strategies. Objectives were to evaluate contemporary physician perspectives and prescribing practices related to rosuvastatin use across the cardiovascular risk continuum and assess alignment with current guideline recommendations.

Methods: A cross-sectional, questionnaire-based survey was conducted among 91 clinicians involved in cardiovascular risk management. The survey assessed rosuvastatin prescribing patterns, dose selection, combination therapy utilization, LDL-C treatment goals, treatment intensification strategies, lipid monitoring practices, post-percutaneous coronary intervention (PCI) lipid management, and integration of lipid-lowering and antiplatelet therapies. Data were analyzed using descriptive statistics and reported as percentages.

Results: Rosuvastatin monotherapy was preferred by 85.4% of clinicians in primary prevention, with rosuvastatin 10 mg being the most frequently prescribed dose (56.1%). Combination therapy use increased with cardiovascular risk, and 62.2% of clinicians preferred combination regimens in secondary prevention. Rosuvastatin plus ezetimibe was the most commonly selected lipid-lowering combination, while rosuvastatin plus aspirin plus clopidogrel was the preferred secondary prevention regimen (44.8%). LDL-C target attainment was the primary driver of treatment intensification, with 55.6% of clinicians targeting LDL-C<70 mg/dl and 44.4% pursuing more aggressive targets. Among high- and very-high-risk ASCVD patients and post-PCI populations, rosuvastatin 40 mg plus ezetimibe 10 mg was the most frequently preferred intensive lipid-lowering strategy. LDL-C remained the primary monitoring parameter, although ApoB and non-HDL-C were increasingly utilized.

Conclusions: Rosuvastatin remains the preferred foundation of lipid-lowering therapy in contemporary clinical practice. Increasing adoption of LDL-C goal-directed treatment intensification, ezetimibe-based combination therapy, prolonged post-PCI lipid management, and integration of lipid-lowering with antiplatelet strategies reflects growing alignment of real-world practice with current evidence-based guideline recommendations.