Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio.
Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland, Ohio.
JAMA Cardiol. 2017 Apr 1;2(4):451-452. doi: 10.1001/jamacardio.2016.5162.
Cardiovascular disease affects 1 in 3 patients and remains the leading cause of death in the United States. Severe elevation of low-density lipoprotein cholesterol (LDL-C) levels is a modifiable risk factor for developing premature cardiovascular disease, and elevation levels of 190 mg/dL or greater (to convert LDL-C values to millimoles per liter, multiply by 0.0259) may indicate a monogenic etiology such as familial hypercholesterolemia. Treatment with 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors or statins is recommended (class IA) for all adults 21 years or older with an LDL-C of 190 mg/dL or greater. Statin treatment appears to reduce mortality and result in cost savings for health systems. Therefore, we sought to examine rates of statin prescription in patients screened for dyslipidemia to identify treatment gaps in a real-world contemporary setting.
心血管疾病影响了 1/3 的患者,仍然是美国的主要死因。低密度脂蛋白胆固醇(LDL-C)水平的严重升高是导致早发性心血管疾病的可改变危险因素,190mg/dL 或更高水平(将 LDL-C 值转换为毫摩尔/升,乘以 0.0259)可能表明存在单基因病因,如家族性高胆固醇血症。对于所有 21 岁或以上 LDL-C 水平为 190mg/dL 或更高的成年人,建议使用 3-羟基-3-甲基戊二酰辅酶 A(HMG-CoA)还原酶抑制剂或他汀类药物治疗(IA 类)。他汀类药物治疗似乎可以降低死亡率并为卫生系统节省成本。因此,我们试图检查在筛查血脂异常的患者中开具他汀类药物的比率,以在真实世界的当代环境中确定治疗差距。