Hermans Michel P, Van Mieghem Walter, Vandenhoven Guy, Vissers Eugène
Department of Diabetology and Nutrition, Université Catholique de Louvain, Woluwe-Saint-Lambert, Brussels.
Acta Cardiol. 2009 Apr;64(2):177-85. doi: 10.2143/AC.64.2.2035341.
The CEntralized Pan-European survey on tHE Under-treatment of hypercholeSterolaemia (CEPHEUS) was initiated to quantify the degree of under-treatment of hypercholesterolaemia in Europe. Its primary objective was to establish the proportion of treated patients reaching the LDL-C goals according to the Third Joint European Task Force guidelines. Secondary objectives targeted subgroups of primary or secondary prevention patients and those with a metabolic syndrome. Further-more, CEPHEUS also aimed at the identification of determinants for under-treatment. Among the patients available for evaluation in Belgium (n=6276), 58.5% reached LDL-C goals as recommended by the 2003 European guidelines, 59.8% in primary prevention, 55.8% in secondary prevention, and 55.8% of those with a metabolic syndrome. The majority of patients (82.5%) was treated with statins. The univariate significant (P < 0.10) predictors of attaining LDL-C goal were the following: (a) nonsmoker, (b) no history of PAD or CAD, (c) absence of metabolic syndrome, (d) lower CV risk category, (e) absence of patient's concerns about treatment changes, (f) no withdrawal of lipid-lowering therapy when on target, (g) optimal. treatment adherence, (h) no patient's frustrations, (i) lipid-monitoring frequency, (j) physician being a specialist and (k) physicians finding it stressful to get patients on target. In an adjusted multi-level model, achievement of the LDL-C goals was significantly associated with: (a) type of lipid-lowering therapy, (b) risk category the patient fell into, (c) LDL-C level before initiating treatment, (d) patient's feelings about the treatment, (e) patient's acknowledgement about current cholesterol level and (f) self-reported drug compliance.
欧洲高胆固醇血症治疗不足集中调查(CEPHEUS)旨在量化欧洲高胆固醇血症治疗不足的程度。其主要目标是根据欧洲第三次联合工作组指南确定达到低密度脂蛋白胆固醇(LDL-C)目标的治疗患者比例。次要目标针对一级或二级预防患者亚组以及患有代谢综合征的患者。此外,CEPHEUS还旨在确定治疗不足的决定因素。在比利时可供评估的患者中(n = 6276),58.5%达到了2003年欧洲指南推荐的LDL-C目标,一级预防患者中这一比例为59.8%,二级预防患者中为55.8%,患有代谢综合征的患者中为55.8%。大多数患者(82.5%)接受了他汀类药物治疗。达到LDL-C目标的单因素显著(P < 0.10)预测因素如下:(a)不吸烟者,(b)无外周动脉疾病(PAD)或冠心病(CAD)病史,(c)无代谢综合征,(d)心血管风险类别较低,(e)患者对治疗变化无担忧,(f)达到目标时未停用降脂治疗,(g)最佳治疗依从性,(h)患者无挫败感,(i)血脂监测频率,(j)医生为专科医生,以及(k)医生认为使患者达到目标有压力。在调整后的多层次模型中,LDL-C目标的实现与以下因素显著相关:(a)降脂治疗类型,(b)患者所属风险类别,(c)开始治疗前的LDL-C水平,(d)患者对治疗的感受,(e)患者对当前胆固醇水平的认知,以及(f)自我报告的药物依从性。