Reda Ashraf, Etman Alaa, Abdel-Rahim Ali, Farag Nabil, Sanad Osama, Salamah Sameh
Monofya University, Egypt, 13127 Mohamed Fareed Street, Bab El-Louk, Cairo, Egypt.
National Heart Institute, Egypt, 1 Mohamed Mahmoud Street, Bab El-Louk, Cairo, Egypt.
Cardiol Ther. 2017 Jun;6(1):105-120. doi: 10.1007/s40119-017-0089-3. Epub 2017 Mar 29.
As part of the CEPHEUS study, CEPHEUS I was conducted in 2010 and 2011 in Cairo and then the CEPHEUS II study was carried out in Alexandria and Delta Regions in Egypt between April 2014 and August 2015 to determine the proportion of dyslipidemic patients on lipid-lowering treatment reaching LDL-C treatment goals.
We conducted an open-label, observational, multicenter, cross-sectional survey where 90 investigators enrolled 1127 patients receiving lipid-lowering drugs for at least 3 months. After signing informed consent forms, the study questionnaires were completed by patients and investigators. Blood samples were taken for laboratory investigations. Patients with missing LDL-C data were excluded from the analysis and results from 896 patients were analyzed according to European Atherosclerosis Society and EAS/ESC 2011 guidelines.
Out of 896 patients enrolled based on the risk stratification of EAS/ESC 2011 guidelines, 12.4% were classified as low risk, 20.0% as moderate risk, 2.5% as high risk, and 65.2% as very high risk. Achievement goals were 84.7, 44.7, 18.2, and 22.3% for low-risk, moderate-risk, high-risk, and very high risk patients, respectively, with an overall achievement goal of 34.4%. The study population included 50.2% diabetes, 64.4% hypertension, 54.9% metabolic syndrome, 32.2% family history of cardiovascular disease, 23.1% smokers, and 33.8% secondary prevention. Lipid-lowering agents were prescribed as a monotherapy to 90.1% and in combination in 9.9% with goal achievements of 34 and 38%, respectively (p > 0.05). Statins were prescribed to 86.9% of patients. The most frequent prescribed statins were rosuvastatin (47.1%) and atorvastatin (36.0%), followed by simvastatin (9.2%). Treatment goal was achieved in 34.2, 36.0, and 31.7% for rosuvastatin, atorvastatin, and simvastatin, respectively, with no significant difference in achievement goals (p > 0.05).
Hypercholesterolemia is still not being effectively managed in many at-risk patients in Egypt. The majority of patients enrolled in the study were being actively treated with lipid-lowering medications yet the percentage goal achievement was less when compared to CEPHEUS results.
作为CEPHEUS研究的一部分，CEPHEUS I于2010年和2011年在开罗开展，随后CEPHEUS II研究于2014年4月至2015年8月在埃及亚历山大港和三角洲地区进行，以确定接受降脂治疗的血脂异常患者达到低密度脂蛋白胆固醇（LDL-C）治疗目标的比例。
我们进行了一项开放标签、观察性、多中心横断面调查，90名研究人员招募了1127名接受降脂药物治疗至少3个月的患者。在签署知情同意书后，患者和研究人员完成了研究问卷。采集血样进行实验室检查。LDL-C数据缺失的患者被排除在分析之外，根据欧洲动脉粥样硬化学会和EAS/ESC 2011指南对896名患者的结果进行了分析。
根据EAS/ESC 2011指南的风险分层，在纳入的896名患者中，12.4%被归类为低风险，20.0%为中度风险，2.5%为高风险，65.2%为极高风险。低风险、中度风险、高风险和极高风险患者的达标率分别为84.7%、44.7%、18.2%和22.3%，总体达标率为34.4%。研究人群包括50.2%的糖尿病患者、64.4%的高血压患者、54.9%的代谢综合征患者、32.2%的心血管疾病家族史患者、23.1%的吸烟者以及33.8%的二级预防患者。90.1%的患者接受单药降脂治疗，9.9%的患者接受联合治疗，达标率分别为34%和38%（p>0.05）。86.9%的患者使用了他汀类药物。最常用的他汀类药物是瑞舒伐他汀（47.1%）和阿托伐他汀（36.0%），其次是辛伐他汀（9.2%）。瑞舒伐他汀、阿托伐他汀和辛伐他汀的治疗达标率分别为34.2%·、36.0%和·31.7%，达标率无显著差异（p>0.05）。
在埃及，许多高危患者的高胆固醇血症仍未得到有效控制。该研究中纳入的大多数患者正在接受积极的降脂药物治疗，但与CEPHEUS研究结果相比，达标百分比更低。
