• Je něco špatně v tomto záznamu ?

Low LDL-C goal attainment in patients at very high cardiovascular risk due to lacking observance of the guidelines on dyslipidaemias

M. Vrablík, I. Šarkanová, K. Breciková, P. Šedová, M. Šatný, A. Tichopád

. 2023 ; 18 (5) : e0272883. [pub] 20230522

Jazyk angličtina Země Spojené státy americké

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc23011398

Dyslipidemias are defined as a wide range of abnormalities of the lipid profile. Treatment guidelines recommend aiming at lowering LDL-C. We investigated the adherence of Czech cardiologists to the dyslipidaemia treatment guidelines, especially in the management of patients with high and very high cardiovascular risk. In this retrospective cross-sectional multicentric study data from medical records of 450 adults with ASCVD, enrolled between June 2021 and January 2022, were analysed. Demographics, clinical outcomes, medical history, LLT treatment and other medications were collected. The physicians were to include patients at a very high risk of ASCVD and to complete a general questionnaire on their personal therapeutic preferences. Objectively assessed, only 80% of total patients (N = 450) enrolled in the study were at very high risk of ASCVD, and 12.7% of patients were at high risk of ASCVD, respectively. In total, 55 (13.1%) patients were diagnosed with familial hypercholesterolemia, and 39.1% of them had a positive family history of ASCVD. Generally, only 20.5% of patients reached the 2019 LDL-C goals- 19.4% of very high risk patients and 28.1% of high risk patients, respectively. 61% of the physicians preferred a slow and careful up-titration of the dose, which is contradictory to the guidelines. Only 17% of the physicians increased the statin dose or added/combined/changed the treatment to achieve the LDL-C goals as soon as possible. Surprisingly, in up to 61.5% of patients at very high risk who did not meet the LDL-C goals, their physicians stated subjective satisfaction with the treatment and considered no change needed. Among very high and high risk patients receiving lipid-lowering therapy, with high treatment adherence, the LDL-C goal attainment is very low and LLT utilization is rather sub-optimal. Improving observance of the guidelines by physicians bears a substantial potential for LDL-C goal attainment and thus improving overall benefit for patients for no additional costs.

Citace poskytuje Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc23011398
003      
CZ-PrNML
005      
20241127144824.0
007      
ta
008      
230718s2023 xxu f 000 0|eng||
009      
AR
024    7_
$a 10.1371/journal.pone.0272883 $2 doi
035    __
$a (PubMed)37216363
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a xxu
100    1_
$a Vrablík, Michal $u 3rd Department of Medicine, General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czech Republic $1 https://orcid.org/0000000272261926 $7 xx0061419
245    10
$a Low LDL-C goal attainment in patients at very high cardiovascular risk due to lacking observance of the guidelines on dyslipidaemias / $c M. Vrablík, I. Šarkanová, K. Breciková, P. Šedová, M. Šatný, A. Tichopád
520    9_
$a Dyslipidemias are defined as a wide range of abnormalities of the lipid profile. Treatment guidelines recommend aiming at lowering LDL-C. We investigated the adherence of Czech cardiologists to the dyslipidaemia treatment guidelines, especially in the management of patients with high and very high cardiovascular risk. In this retrospective cross-sectional multicentric study data from medical records of 450 adults with ASCVD, enrolled between June 2021 and January 2022, were analysed. Demographics, clinical outcomes, medical history, LLT treatment and other medications were collected. The physicians were to include patients at a very high risk of ASCVD and to complete a general questionnaire on their personal therapeutic preferences. Objectively assessed, only 80% of total patients (N = 450) enrolled in the study were at very high risk of ASCVD, and 12.7% of patients were at high risk of ASCVD, respectively. In total, 55 (13.1%) patients were diagnosed with familial hypercholesterolemia, and 39.1% of them had a positive family history of ASCVD. Generally, only 20.5% of patients reached the 2019 LDL-C goals- 19.4% of very high risk patients and 28.1% of high risk patients, respectively. 61% of the physicians preferred a slow and careful up-titration of the dose, which is contradictory to the guidelines. Only 17% of the physicians increased the statin dose or added/combined/changed the treatment to achieve the LDL-C goals as soon as possible. Surprisingly, in up to 61.5% of patients at very high risk who did not meet the LDL-C goals, their physicians stated subjective satisfaction with the treatment and considered no change needed. Among very high and high risk patients receiving lipid-lowering therapy, with high treatment adherence, the LDL-C goal attainment is very low and LLT utilization is rather sub-optimal. Improving observance of the guidelines by physicians bears a substantial potential for LDL-C goal attainment and thus improving overall benefit for patients for no additional costs.
650    _2
$a dospělí $7 D000328
650    _2
$a lidé $7 D006801
650    _2
$a LDL-cholesterol $7 D008078
650    12
$a kardiovaskulární nemoci $x prevence a kontrola $x farmakoterapie $7 D002318
650    _2
$a retrospektivní studie $7 D012189
650    _2
$a průřezové studie $7 D003430
650    _2
$a cíle $7 D006040
650    _2
$a rizikové faktory $7 D012307
650    _2
$a výsledek terapie $7 D016896
650    12
$a statiny $x terapeutické užití $7 D019161
650    12
$a dyslipidemie $x farmakoterapie $x diagnóza $7 D050171
650    12
$a hypolipoproteinemie $7 D007009
650    _2
$a rizikové faktory kardiovaskulárních chorob $7 D000082742
655    _2
$a časopisecké články $7 D016428
700    1_
$a Šarkanová, Ivana $u CEEOR, Prague, Czech Republic $7 xx0326508
700    1_
$a Lejavová, Katarína, $u CEEOR, Prague, Czech Republic $d 1987- $7 xx0326522
700    1_
$a Šedová, Petra $u Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, University Hospital Brno, Brno, Czech Republic $u Department of Neurology, International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic $u Department of Neurology, Mayo Clinic, Rochester, MN, United States of America $1 https://orcid.org/0000000213790203
700    1_
$a Šatný, Martin $u 3rd Department of Medicine, General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czech Republic
700    1_
$a Tichopád, Aleš $u Department of Biomedical Technology, Czech Technical University in Prague, Prague, Czech Republic $1 https://orcid.org/0000000213080877
773    0_
$w MED00180950 $t PloS one $x 1932-6203 $g Roč. 18, č. 5 (2023), s. e0272883
856    41
$u https://pubmed.ncbi.nlm.nih.gov/37216363 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y p $z 0
990    __
$a 20230718 $b ABA008
991    __
$a 20241127144818 $b ABA008
999    __
$a ok $b bmc $g 1963675 $s 1197663
BAS    __
$a 3
BAS    __
$a PreBMC-MEDLINE
BMC    __
$a 2023 $b 18 $c 5 $d e0272883 $e 20230522 $i 1932-6203 $m PLoS One $n PLoS One $x MED00180950
LZP    __
$a Pubmed-20230718

Najít záznam

Citační ukazatele

Možnosti archivace