INTRODUCTION: Cardiovascular events are still the most common cause of death in the Czech Republic. The increasing prevalence of risk factors such as dyslipidaemia, hypertension, obesity, and diabetes individually and collectively contribute to cardiovascular events. The aim of this study was to determine their prevalence and interrelationships. METHOD: The data for this epidemiological study were obtained from the Czech cross-sectional study EHES 2019 (European Health Examination Survey) with stratified random sampling. Firstly, individual risk factors (dyslipidaemia, hypertension, obesity, diabetes, and smoking) in population aged 25-64 years of age were monitored using questionnaires and physical and laboratory measurements; additionally, the cumulative effect of these risk factors in subjects was examined. Finally, cardiovascular risk in the age group of 40-64 years (767 out of 1057 participants) was estimated using the SCORE EU chart (for countries with high cardiovascular risk). Individual parameters were assessed according to standard criteria: dyslipidaemia = total cholesterol ≥5.0 mmol/l, and/or HDL-C < 1.0 mmol/l in men, or <1.2 mmol/l in women, and/or LDL-C ≥ 3.0 mmol/l and/or fasting TAG ≥ 1.7 mmol/l (or ≥2 mmol/l without fasting) and/or medication with lipid-lowering drugs; obesity = BMI > 30 kg/m2; hypertension = systolic blood pressure ≥ 140 mmHg, and/or diastolic blood pressure ≥ 90 mmHg, and/or antihypertensive treatment; diabetes mellitus = HbA1c ≥ 48 mmol/mol and/or on treatment. Data were analysed by descriptive statistics. RESULTS: Of the total number of 1057 study participants (426 men and 631 women) aged 25-64 years, roughly 84% presented with ≥1 cardiovascular disease risk factor. The most common risk factor was dyslipidaemia, which occurred in 71.7% of the subjects. The prevalence of hypertension was 36.3% (men 46.0%, women 26.3%). 29.7% of subjects were obese, diabetes mellitus occurred in 5.7% (men 7.6%, women 3.7%). 17.7% were regular smokers; another 6.6% reported occasional smoking. A combination of risk factors was common, e.g., 77.3% had dyslipidaemia and/or hypertension. There were 16.1% of subjects without monitored cardiovascular risk factors. After stratification of cardiovascular risk prediction according to SCORE chart, 49.7% of individuals fall into low risk, 28.6% into medium risk, and up to 11.3% into high and 10.4% into very high risk. CONCLUSION: The most common risk factor is lipid spectrum disorders (71.7%). Combination of risk factors is common, which increases the risk of cardiovascular events in these individuals. In the 40-64 age group, 21.7% of the population is at >5% risk of a fatal cardiovascular event over the next 10 years.

• MeSH
• diabetes mellitus epidemiologie   MeSH
• dospělí MeSH
• dyslipidemie epidemiologie   MeSH
• hypertenze epidemiologie   MeSH
• kardiovaskulární nemoci * epidemiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• obezita epidemiologie   MeSH
• prevalence MeSH
• průřezové studie MeSH
• rizikové faktory kardiovaskulárních chorob * MeSH
• rizikové faktory MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

BACKGROUND: Performance-based risk-sharing agreements (PBRSA) represent an innovative tool for managing uncertainty and balanced distribution of the financial risk of high-cost drugs. By linking reimbursement to real-world treatment performance, these agreements help mitigate budgetary impacts. This study poses an illustrative patient-level PBRSA reimbursement model for non-small cell lung cancer (NSCLC) immunotherapy based on collected real-world data (RWD). METHODS: A retrospective analysis of 266 patients with NSCLC treated with immunotherapy was performed. Progression-free survival (PFS) served as the primary outcome measure of therapeutic effectiveness. An illustrative patient-level PBRSA model was developed to quantify the manufacturer’s financial participation based on deviations from established PFS thresholds reported in randomised controlled trials (RCT). The manufacturer’s financial responsibility increased proportionally to greater deviations in patient outcomes from the RCT benchmark. Cost calculations were limited exclusively to the acquisition price of immunotherapies, excluding administration, toxicity management, and other indirect costs. The potential PBRSA scenario was compared with the current reimbursement situation. RESULTS: Using this reimbursement method, cost savings per checkpoint inhibitor for healthcare payers could represent between 27.3% and 66.2% of the total cost, depending on the individual PFS reached. For the RWD cohort of NSCLC patients unsuccessfully treated with pembrolizumab monotherapy was 57.5% (a reduction in cost to payers from $27 996 to $11 893 per patient); pembrolizumab in combination 51.7% ($33 595 to $16 237); nivolumab 37.1% ($5 608 to $3 531); atezolizumab 27.3% ($11 799 to $8 583); and durvalumab 66.2% ($44 005 to $14 882). CONCLUSIONS: This study proposes an illustrative patient-level PBRSA reimbursement model leveraging real-world clinical data to enhance risk-sharing for high-cost therapies. Unlike conventional cost-effectiveness analyses, this method directly links clinical performance and manufacturer financial responsibility. Future research should integrate comprehensive cost considerations and validate model performance in broader clinical settings. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13561-025-00646-3.

• Publikační typ
• časopisecké články MeSH

INTRODUCTION: This prospective study aimed to evaluate the functional status and risk factors in patients undergoing lung resection. METHODS: Functional status defined by the parameters of spirometry (VC, FVC, FEV1, FEV1/FVC) and whole-body plethysmography (TLC) examination was assessed before lung resection, at hospital discharge, 3 weeks after surgery, and 3 months after surgery. RESULTS: The sample comprised 24 participants who were observed from 5/2021 to 10/2022. The functional status worsened significantly after the surgery, but the lung function values improved over time. CONCLUSIONS: Lung functions dropped sharply after the surgery but improved over time.

• Klíčová slova
• functional status, lung resection, spirometry, whole-body plethysmography,
• Publikační typ
• časopisecké články MeSH