Low Rates of Both Lipid-Lowering Therapy Use and Achievement of Low-Density Lipoprotein Cholesterol Targets in Individuals at High-Risk for Cardiovascular Disease across Europe

被引:26
作者
Halcox, Julian P. [1 ]
Tubach, Florence [2 ,3 ,4 ]
Lopez-Garcia, Esther [5 ,6 ]
De Backer, Guy [7 ]
Borghi, Claudio [8 ]
Dallongeville, Jean [9 ]
Guallar, Eliseo [10 ,11 ,12 ,13 ]
Medina, Jesus [14 ]
Perk, Joep [15 ]
Sazova, Oguen [16 ]
Sweet, Stephen [17 ]
Roy, Carine [2 ,3 ]
Banegas, Jose R. [5 ,6 ]
Rodriguez-Artalejo, Fernando [5 ,6 ]
机构
[1] Swansea Univ, Coll Med, Inst Life Sci 2, Swansea, W Glam, Wales
[2] Hop Bichat Claude Bernard, AP HP, INSERM, CIC EC 1425, F-75877 Paris, France
[3] Hop Bichat Claude Bernard, AP HP, Epidemiol & Clin Res Dept, F-75877 Paris, France
[4] Univ Paris Diderot, Sorbonne Paris Cite, UMR 1123, Paris, France
[5] Univ Autonoma Madrid, IdiPaz, Dept Preventat Med & Publ Hlth, Madrid, Spain
[6] CIBERESP, Madrid, Spain
[7] Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium
[8] Univ Bologna, Dept Internal Med, Bologna, Italy
[9] Univ Lille Nord France, Inst Pasteur Lille, INSERM, U 744, Lille, France
[10] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA
[11] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Med, Baltimore, MD USA
[12] Johns Hopkins Bloomberg Sch Publ Hlth, Welch Ctr Prevent Epidemiol & Clin Res, Baltimore, MD USA
[13] Natl Ctr Cardiovasc Res, Dept Cardiovasc Epidemiol & Populat Genet, Madrid, Spain
[14] AstraZeneca Farmaceut Spain, Global Med Affairs, Observat Res Ctr, Madrid, Spain
[15] Linnaeus Univ, Sch Hlth & Caring Sci, Kalmar, Sweden
[16] AstraZeneca Global Med Affairs, London, England
[17] Oxford PharmaGenesis Ltd, Res Evaluat Unit, Oxford, England
来源
PLOS ONE | 2015年 / 10卷 / 02期
关键词
ADULT-POPULATION; PREVALENCE; MANAGEMENT; METAANALYSIS; PREVENTION; SPAIN;
D O I
10.1371/journal.pone.0115270
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Aims To analyse the treatment and control of dyslipidaemia in patients at high and very high cardiovascular risk being treated for the primary prevention of cardiovascular disease (CVD) in Europe. Methods and Results Data were assessed from the European Study on Cardiovascular Risk Prevention and Management in Usual Daily Practice (EURIKA, ClinicalTrials.gov identifier: NCT00882336), which included a randomly sampled population of primary CVD prevention patients from 12 European countries (n = 7641). Patients' 10-year risk of CVD-related mortality was calculated using the Systematic Coronary Risk Evaluation (SCORE) algorithm, identifying 5019 patients at high cardiovascular risk (SCORE >= 5% and/or receiving lipid-lowering therapy), and 2970 patients at very high cardiovascular risk (SCORE >= 10% or with diabetes mellitus). Among high-risk individuals, 65.3% were receiving lipid-lowering therapy, and 61.3% of treated patients had uncontrolled low-density lipoprotein cholesterol (LDL-C) levels (>= 2.5 mmol/L). For very-high-risk patients (uncontrolled LDL-C levels defined as >= 1.8 mmol/L) these figures were 49.5% and 82.9%, respectively. Excess 10-year risk of CVD-related mortality (according to SCORE) attributable to lack of control of dyslipidaemia was estimated to be 0.72% and 1.61% among high-risk and very-high-risk patients, respectively. Among high-risk individuals with uncontrolled LDL-C levels, only 8.7% were receiving a high-intensity statin (atorvastatin >= 40 mg/day or rosuvastatin >= 20 mg/day). Among very-high-risk patients, this figure was 8.4%. Conclusions There is a considerable opportunity for improvement in rates of lipid-lowering therapy use and achievement of lipid-level targets in high-risk and very-high-risk patients being treated for primary CVD prevention in Europe.
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页数:11
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