1st Department of Cardiology, Banacha 1a, 02-097 Warsaw, Poland.
Kardiol Pol. 2018;76(3):648-654. doi: 10.5603/KP.2018.0004. Epub 2018 Jan 9.
Dyslipidaemia, especially elevated low-density lipoprotein cholesterol (LDL-C), is one of the most important cardiovascular risk factors. Treatment of dyslipidaemia and prevention of cardiovascular disease (CVD) with lipid-lowering drugs is one of the key issues in reducing cardiovascular mortality. Nevertheless, underutilisation of statins and lipid-lowering drugs is still a problem globally.
The present study aimed to describe the utilisation of lipid-lowering drugs in groups of patients with indications for statin treatment and elevated LDL-C.
The study included adult patients with an indication for the use of a lipid-lowering therapy, currently using or not using such therapy because of contraindications or statin intolerance, in whom LDL-C concentration was > 70 mg/dL, treated in outpatient settings. All patients were screened for CVD and had blood cholesterol concentration assessed. Patients were also divided into: (1) patients with vascular disease; (2) patients with diabetes mellitus; (3) aged ≥ 65 years; and (4) patients without the three mentioned risk factors.
The study group consisted of 2812 (51.4% male) patients. Major cardiovascular risk factors including arterial hyper-tension, type 2 diabetes mellitus, and smoking were highly prevalent in the study population (86.2%, 44.1%, and 23.3%, respectively). Out of the prespecified risk factors (vascular disease, diabetes mellitus, age ≥ 65 years) the study population was divided into patients without any of the mentioned risk factors (n = 520), those with all the three risk factors (n = 368), two out of three risk factors (n = 934), and one risk factor (n = 990). The study showed that 89.6% of patients were treated with statins (47.8% with atorvastatin, 27.8% with rosuvastatin, and 13.8% with simvastatin). Fenofibrate was used in 5.8% of the population and ezetimibe in 2.7%. In the whole group, 7.1% of patients did not receive any type of lipid-lowering therapy. Atorvastatin was more often used in patients with all the three prespecified risk factors, while rosuvastatin was used in patients without any of the risk factors.
The most often-used lipid-lowering drugs in Poland are statins, with atorvastatin and rosuvastatin being used the most common of these. The present study shows that some patients with LDL-C concentration > 70 mg/dL and indications for lipid-lowering are not treated accordingly.
血脂异常，尤其是低密度脂蛋白胆固醇（LDL-C）升高，是最重要的心血管危险因素之一。用降脂药物治疗血脂异常和预防心血管疾病（CVD）是降低心血管死亡率的关键问题之一。然而，他汀类药物和降脂药物的使用率不足仍然是一个全球性问题。
本研究旨在描述具有他汀类药物治疗指征和 LDL-C 升高的患者群体中降脂药物的使用情况。
本研究纳入了有降脂治疗指征的成年患者，目前因禁忌证或他汀类药物不耐受而正在使用或未使用降脂治疗，其 LDL-C 浓度>70mg/dL，在门诊环境中接受治疗。所有患者均进行 CVD 筛查，并检测血胆固醇浓度。患者还分为：（1）有血管疾病的患者；（2）有糖尿病的患者；（3）年龄≥65 岁的患者；（4）无上述三种危险因素的患者。
研究组包括 2812 名（51.4%为男性）患者。研究人群中存在多种主要心血管危险因素，包括动脉高血压、2 型糖尿病和吸烟，其患病率分别为 86.2%、44.1%和 23.3%。在规定的危险因素（血管疾病、糖尿病、年龄≥65 岁）中，研究人群被分为无任何上述危险因素的患者（n=520）、有上述所有三种危险因素的患者（n=368）、有两种危险因素的患者（n=934）和有一种危险因素的患者（n=990）。研究表明，89.6%的患者接受了他汀类药物治疗（47.8%为阿托伐他汀，27.8%为瑞舒伐他汀，13.8%为辛伐他汀）。有 5.8%的人群使用了非诺贝特，2.7%的人群使用了依折麦布。在整个研究人群中，有 7.1%的患者未接受任何类型的降脂治疗。阿托伐他汀在具有所有三种规定危险因素的患者中更为常用，而瑞舒伐他汀在无任何危险因素的患者中更为常用。
波兰最常使用的降脂药物是他汀类药物，其中阿托伐他汀和瑞舒伐他汀的使用最为常见。本研究表明，一些 LDL-C 浓度>70mg/dL 且有降脂指征的患者未得到相应治疗。
