EU-Wide Cross-Sectional Observational Study of Lipid-Modifying Therapy Use in Secondary and Primary Care: the DA VINCI study
Language English Country England, Great Britain Media print
Document type Journal Article, Observational Study, Research Support, Non-U.S. Gov't
PubMed
33580789
DOI
10.1093/eurjpc/zwaa047
PII: 5898664
Knihovny.cz E-resources
- Keywords
- Cholesterol, Guidelines, Lipids, Registry, Statins,
- MeSH
- Anticholesteremic Agents * adverse effects MeSH
- Biomarkers MeSH
- Dyslipidemias * drug therapy MeSH
- Cardiovascular Diseases * diagnosis epidemiology prevention & control MeSH
- Cholesterol, LDL MeSH
- Humans MeSH
- Primary Health Care MeSH
- Proprotein Convertase 9 MeSH
- Cross-Sectional Studies MeSH
- Risk Factors MeSH
- Hydroxymethylglutaryl-CoA Reductase Inhibitors * therapeutic use MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Observational Study MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Anticholesteremic Agents * MeSH
- Biomarkers MeSH
- Cholesterol, LDL MeSH
- PCSK9 protein, human MeSH Browser
- Proprotein Convertase 9 MeSH
- Hydroxymethylglutaryl-CoA Reductase Inhibitors * MeSH
AIMS: To provide contemporary data on the implementation of European guideline recommendations for lipid-lowering therapies (LLTs) across different settings and populations and how this impacts low-density lipoprotein cholesterol (LDL-C) goal achievement. METHODS AND RESULTS: An 18 country, cross-sectional, observational study of patients prescribed LLT for primary or secondary prevention in primary or secondary care across Europe. Between June 2017 and November 2018, data were collected at a single visit, including LLT in the preceding 12 months and most recent LDL-C. Primary outcome was the achievement of risk-based 2016 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) LDL-C goal while receiving stabilized LLT; 2019 goal achievement was also assessed. Overall, 5888 patients (3000 primary and 2888 secondary prevention patients) were enrolled; 54% [95% confidence interval (CI) 52-56] achieved their risk-based 2016 goal and 33% (95% CI 32-35) achieved their risk-based 2019 goal. High-intensity statin monotherapy was used in 20% and 38% of very high-risk primary and secondary prevention patients, respectively. Corresponding 2016 goal attainment was 22% and 45% (17% and 22% for 2019 goals) for very high-risk primary and secondary prevention patients, respectively. Use of moderate-high-intensity statins in combination with ezetimibe (9%), or any LLT with PCSK9 inhibitors (1%), was low; corresponding 2016 and 2019 goal attainment was 53% and 20% (ezetimibe combination), and 67% and 58% (PCSK9i combination). CONCLUSION: Gaps between clinical guidelines and clinical practice for lipid management across Europe persist, which will be exacerbated by the 2019 guidelines. Even with optimized statins, greater utilization of non-statin LLT is likely needed to reduce these gaps for patients at highest risk.
Advanced Lipid Management and Research Centre Tallaght University Hospital Dublin 24 Ireland
Amgen Hellas 4 Gravias Street Maroussi 15125 Athens Greece
Amgen Inc 1 Amgen Center Drive Thousand Oaks CA 91320 USA
Cardiology Department Sahlgrenska University Hospital 413 45 Gothenburg Sweden
Cardiovascular Research Centre University of Zielona Góra 65 417 Zielona Góra Poland
Centre Cardiologique et Vasculaire 36 Route de la Briquerie 57100 Thionville France
Charles University Prague 116 36 Czech Republic
Cliniques Universitaires Saint Luc Avenue Hippocrate 10 1200 Brussels Belgium
Department of Family Medicine and Public Health Faculty of Medicine University of Opole Opole Poland
Department of Molecular and Clinical Medicine University of Gothenburg 405 30 Gothenburg Sweden
Emergency Cardiology Department Institute of Cardiology Kiev Ukraine
Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
Global Biostatistical Science Amgen Ltd 240 Cambridge Science Park Milton Road Cambridge CB4 0WD UK
Hungarian Army Medical Center Budapest 1134 Hungary
Imperial Clinical Trials Unit Imperial College London Stadium House 68 Wood Lane London W12 7RH UK
Imperial Hospitals NHS Trust London W12 0HS UK
IRCCS MultiMedica Via Milanese 300 20099 Sesto San Giovanni Milan Italy
Krankenhaus Barmherzige Schwestern Linz Seilerstðtte 4 4010 Seilerstätte 4 4010 Linz Austria
Leiden University Medical Center Albinusdreef 2 2333 ZA Leiden Netherlands
National and Kapodistrian University of Athens Medical School Athens Greece
Polish Mother's Memorial Hospital Research Institute 93 338 Lodz Poland
Polyclinic for Endocrinology Diabetes and Preventive Medicine Kerpener Str 62 50937 Cologne Germany
Slovak Medical University 831 01 Bratislava Slovakia
Trinity College Dublin Dublin 2 Ireland
Universitat Rovira i Virgili IISPV CIBERDEM Saint Joan University Hospital Reus Spain
University of Amsterdam Faculty of Medicine Amsterdam the Netherlands
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