Περίληψη:
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.
Συγγραφείς:
Ray, Kausik K.
Molemans, Bart
Schoonen, W. Marieke
Giovas,
Periklis
Bray, Sarah
Kiru, Gaia
Murphy, Jennifer
Banach,
Maciej
De Servi, Stefano
Gaita, Dan
Gouni-Berthold, Ioanna
and Hovingh, G. Kees
Jozwiak, Jacek J.
Jukema, J. Wouter and
Kiss, Robert Gabor
Kownator, Serge
Iversen, Helle K.
Maher,
Vincent
Masana, Luis
Parkhomenko, Alexander
Peeters, Andre
and Clifford, Piers
Raslova, Katarina
Siostrzonek, Peter and
Romeo, Stefano
Tousoulis, Dimitrios
Vlachopoulos, Charalambos
and Vrablik, Michal
Catapano, Alberico L.
Poulter, Neil R. and
DA VINCI study
