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加拿大高胆固醇血症患者的他汀类药物治疗:加拿大脂质研究——观察性研究(CALIPSO)

Statin therapy in Canadian patients with hypercholesterolemia: the Canadian Lipid Study -- Observational (CALIPSO).

作者信息

Bourgault C, Davignon Jean, Fodor George, Gagné Claude, Gaudet Daniel, Genest Jacques, Lavoie Marc-Andre, Leiter Lawrence, McPherson Ruth, Sénécal Martin, Marentette Michael, Sebaldt Rolf J

机构信息

McGill University, Montreal, Canada.

出版信息

Can J Cardiol. 2005 Nov;21(13):1187-93.

Abstract

BACKGROUND

Although statins are widely used to reduce low density lipoprotein cholesterol (LDL-C), there is little information about patient profiles, treatment patterns and goal achievement among statin-treated patients in Canada.

OBJECTIVES

To assess the profile of statin-treated patients and to determine whether they are achieving recommended targets for LDL-C.

METHODS

The Canadian Lipid Study -- Observational (CALIPSO) was a cross-sectional study involving Canadian physicians who were among the top statin prescribers. Each physician enrolled up to 15 patients who were at least 18 years of age with a diagnosis of hyper-cholesterolemia and who had been using a statin for at least eight weeks. Sociodemographics, coronary artery disease (CAD) risk factors, pretreatment and current lipid levels, and history of lipid-lowering therapy were reported for 3721 patients.

RESULTS

Sixty-eight per cent of statin-treated patients were at high CAD risk according to the 2003 Canadian guidelines, 46.4% had established cardiovascular disease, 33.9% had diabetes and 59.5% had hypertension. Average LDL-C reductions of 32% (37% for high-risk patients) were initially required to reach goal. At the study visit, patients had been treated for an average of 4.3 years and 24.2% were using a high statin dose. Despite statin therapy, 27.2% of all patients and 36.4% of those at high CAD risk had not achieved LDL-C targets. For 67.4% of these patients, the current therapy was not modified at the study visit.

CONCLUSIONS

Despite effective therapies, many treated patients are not achieving recommended LDL-C targets. Strategies should be implemented to promote achievement of lipid treatment goals for high-risk patients, thereby reducing the risk of cardiovascular events and their associated clinical and economic burdens.

摘要

背景

尽管他汀类药物被广泛用于降低低密度脂蛋白胆固醇(LDL-C),但在加拿大接受他汀类药物治疗的患者中,关于患者特征、治疗模式和目标达成情况的信息却很少。

目的

评估接受他汀类药物治疗的患者特征,并确定他们是否达到了LDL-C的推荐目标。

方法

加拿大脂质研究——观察性研究(CALIPSO)是一项横断面研究,涉及加拿大他汀类药物处方量最大的医生。每位医生招募至多15名年龄至少18岁、诊断为高胆固醇血症且使用他汀类药物至少8周的患者。报告了3721例患者的社会人口统计学特征、冠状动脉疾病(CAD)危险因素、治疗前和当前的血脂水平以及降脂治疗史。

结果

根据2003年加拿大指南,68%接受他汀类药物治疗的患者处于高CAD风险,46.4%患有已确诊的心血管疾病,33.9%患有糖尿病,59.5%患有高血压。最初平均需要将LDL-C降低32%(高危患者为37%)才能达到目标。在研究访视时,患者平均接受治疗4.3年,24.2%的患者使用高剂量他汀类药物。尽管接受了他汀类药物治疗,但所有患者中有27.2%以及高CAD风险患者中有36.4%未达到LDL-C目标。对于这些患者中的67.4%,在研究访视时未调整当前治疗方案。

结论

尽管有有效的治疗方法,但许多接受治疗的患者并未达到推荐的LDL-C目标。应实施策略以促进高危患者实现血脂治疗目标,从而降低心血管事件风险及其相关的临床和经济负担。

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