Roden Michael, Huber Kurt
1. Med. Abteilung, Hanusch-Krankenhaus, Karl-Landsteiner-Institut für Endokrinologie und Stoffwechsel, Wien, Austria.
Wien Klin Wochenschr. 2008;120(17-18):558-65. doi: 10.1007/s00508-008-1010-9.
Cardiovascular disease is the major cause of morbidity and premature death in most European populations. Due to its prominent role as a risk factor for cardiovascular mortality, lowering of low density lipoprotein cholesterol (LDL-C) levels is the main goal for management of dyslipidemia. To evaluate lipid profiles and management of high risk patients with hyperlipidemia, we performed an observational study in 20 Austrian Departments of Medicine specialized in cardiology, diabetes and/or metabolism from July 2006 to February 2007. Out of 9152 patients [age (mean +/- SD): women 69 +/- 13, men 65 +/- 12 years) 6838 were considered at "very high risk" (group 1; LDL-C: 99 +/- 38 mg/dl) and 2314 at "high risk" (group 2; LDL-C: 108 +/- 39 mg/dl), respectively. Of 4886 patients on statins, 48% of did not reach their LDL-C goals (<70 mg/dl and <100 mg/dl for group 1 and 2, respectively). In 68% of these patients statin therapy was not intensified subsequently. Among patients without lipid-lowering drugs at study entry, 62% did not meet their targets, and despite treatment in the center 1555 of these patients (58%) remained without medication. With regard to national and international guidelines, there is still a need to improve the clinical practice of lowering LDL-C for secondary prevention in high risk patients in Austria.
心血管疾病是大多数欧洲人群发病和过早死亡的主要原因。由于其作为心血管疾病死亡风险因素的突出作用,降低低密度脂蛋白胆固醇(LDL-C)水平是血脂异常管理的主要目标。为了评估高脂血症高危患者的血脂谱和管理情况,我们于2006年7月至2007年2月在奥地利20个专门从事心脏病学、糖尿病和/或代谢病的医学科室进行了一项观察性研究。在9152名患者中[年龄(平均±标准差):女性69±13岁,男性65±12岁],分别有6838名被视为“极高危”(第1组;LDL-C:99±38mg/dl)和2314名被视为“高危”(第2组;LDL-C:108±39mg/dl)。在4886名服用他汀类药物的患者中,48%未达到其LDL-C目标(第1组和第2组分别为<70mg/dl和<100mg/dl)。在这些患者中,68%的患者他汀类药物治疗随后未强化。在研究开始时未服用降脂药物的患者中,62%未达到目标,尽管在该中心进行了治疗,但这些患者中有1555名(58%)仍未用药。关于国家和国际指南,奥地利高危患者二级预防中降低LDL-C的临床实践仍有必要改进。