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欧洲心血管疾病一级预防中致动脉粥样硬化性血脂异常的患病率及治疗情况:EURIKA横断面观察性研究

Prevalence and treatment of atherogenic dyslipidemia in the primary prevention of cardiovascular disease in Europe: EURIKA, a cross-sectional observational study.

作者信息

Halcox Julian P, Banegas José R, Roy Carine, Dallongeville Jean, De Backer Guy, Guallar Eliseo, Perk Joep, Hajage David, Henriksson Karin M, Borghi Claudio

机构信息

Institute of Life Sciences 2, Swansea University College of Medicine, Singleton Park, Swansea, SA2 8PP, UK.

Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz and CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.

出版信息

BMC Cardiovasc Disord. 2017 Jun 17;17(1):160. doi: 10.1186/s12872-017-0591-5.

Abstract

BACKGROUND

Atherogenic dyslipidemia is associated with poor cardiovascular outcomes, yet markers of this condition are often ignored in clinical practice. Here, we address a clear evidence gap by assessing the prevalence and treatment of two markers of atherogenic dyslipidemia: elevated triglyceride levels and low levels of high-density lipoprotein cholesterol.

METHODS

This cross-sectional observational study assessed the prevalence of two atherogenic dyslipidemia markers, high triglyceride levels and low high-density lipoprotein cholesterol levels, in the study population from the European Study on Cardiovascular Risk Prevention and Management in Usual Daily Practice (EURIKA; N = 7641; of whom 51.6% were female and 95.6% were White/Caucasian). The EURIKA population included European patients, aged at least 50 years with at least one cardiovascular risk factor but no history of cardiovascular disease.

RESULTS

Over 20% of patients from the EURIKA population have either triglyceride or high-density lipoprotein cholesterol levels characteristic of atherogenic dyslipidemia. Furthermore, the proportions of patients with one of these markers were higher in subpopulations with type 2 diabetes mellitus or those already calculated to be at high risk of cardiovascular disease. Approximately 55% of the EURIKA population who have markers of atherogenic dyslipidemia are not receiving lipid-lowering therapy.

CONCLUSIONS

A considerable proportion of patients with at least one major cardiovascular risk factor in the primary cardiovascular disease prevention setting have markers of atherogenic dyslipidemia. The majority of these patients are not receiving optimal treatment, as specified in international guidelines, and thus their risk of developing cardiovascular disease is possibly underestimated.

TRIAL REGISTRATION

The present study is registered with ClinicalTrials.gov (ID: NCT00882336).

摘要

背景

致动脉粥样硬化性血脂异常与不良心血管结局相关,但在临床实践中,这种情况的标志物常常被忽视。在此,我们通过评估致动脉粥样硬化性血脂异常的两个标志物的患病率及治疗情况,来填补明显的证据空白:甘油三酯水平升高和高密度脂蛋白胆固醇水平降低。

方法

这项横断面观察性研究评估了来自欧洲日常实践中心血管疾病风险预防与管理研究(EURIKA;N = 7641;其中51.6%为女性,95.6%为白人/高加索人)的研究人群中两个致动脉粥样硬化性血脂异常标志物,即高甘油三酯水平和低高密度脂蛋白胆固醇水平的患病率。EURIKA人群包括年龄至少50岁、至少有一个心血管危险因素但无心血管疾病病史的欧洲患者。

结果

EURIKA人群中超过20%的患者存在致动脉粥样硬化性血脂异常特征的甘油三酯或高密度脂蛋白胆固醇水平。此外,在2型糖尿病亚组人群或那些已被计算为心血管疾病高风险的人群中,具有这些标志物之一的患者比例更高。EURIKA人群中约55%有致动脉粥样硬化性血脂异常标志物的患者未接受降脂治疗。

结论

在原发性心血管疾病预防环境中,相当一部分至少有一个主要心血管危险因素的患者存在致动脉粥样硬化性血脂异常标志物。这些患者中的大多数未按照国际指南的规定接受最佳治疗,因此他们发生心血管疾病的风险可能被低估。

试验注册

本研究已在ClinicalTrials.gov注册(ID:NCT00882336)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d51/5473961/e91104dafa4f/12872_2017_591_Fig1_HTML.jpg

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