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国家间心血管风险筛查项目的差异可能会阻碍欧洲心血管预防研究的理解。

National differences in screening programmes for cardiovascular risks could obstruct understanding of cardiovascular prevention studies in Europe.

机构信息

Medical Faculty, Leiden University Medical Centre, Leiden, the Netherlands,

出版信息

Neth Heart J. 2011 Nov;19(11):458-63. doi: 10.1007/s12471-011-0183-4.

Abstract

INTRODUCTION

In North-West Europe, cardiovascular disease is still a major cause of death and despite several efforts (e.g. European guidelines and conferences) cardiovascular risk factors are still inconsistently diagnosed and treated.

METHODS

We evaluated the first consultations of patients in two cardiovascular referral clinics in France and the Netherlands, while evaluating the differences in national guidelines and between the profiles of patients at their first consultation.

RESULTS

Notable differences exist between the two locally used guidelines in their programmes of cardiovascular risk assessment and their definition of LDL-cholesterol target levels. With regard to the LDL-cholesterol levels, more patients are 'on target' when using the French guideline than when using the Dutch guideline. Evaluation of the patient's profile at first presentation showed that the LDL-cholesterol levels were significantly lower in the Dutch patients (n = 77) compared with the French patients (n = 119). Dutch patients used significantly more statins than French patients.

CONCLUSION

Despite the small study population included in this study, we found that comparison of daily care (as part of a primary prevention programme) is rather difficult due to several national differences in the approach to patients. All these factors combined should be taken into account, when discussing and extrapolating results obtained from analysis of cardiovascular prevention programmes.

摘要

简介

在西北欧,心血管疾病仍然是主要死因,尽管已经做出了一些努力(例如欧洲指南和会议),但心血管危险因素的诊断和治疗仍不一致。

方法

我们评估了法国和荷兰两家心血管转诊诊所的患者首次就诊时的情况,同时评估了两国指南之间以及患者首次就诊时的特征差异。

结果

在心血管风险评估方案和 LDL-胆固醇目标水平的定义方面,两种当地使用的指南之间存在显著差异。使用法国指南时,“达标”的患者比例高于使用荷兰指南时。对患者首次就诊时的特征评估表明,与法国患者(n=119)相比,荷兰患者(n=77)的 LDL-胆固醇水平显著降低。荷兰患者使用的他汀类药物明显多于法国患者。

结论

尽管本研究的研究人群规模较小,但我们发现,由于在患者处理方面存在一些国家差异,日常护理(作为初级预防计划的一部分)的比较相当困难。在讨论和推断心血管预防计划分析结果时,应考虑所有这些综合因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ec1/3203985/ea189850787f/12471_2011_183_Fig1_HTML.jpg

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