Third Department of Internal Medicine, General University Hospital and First Faculty of Medicine, Charles University, U Nemocnice 1, 128 08 Prague 2, Czech Republic.
Coordination Centre for Familial Hypercholesterolemia and Institute of Nutrition, Slovak Medical University, Limbova 14, 833 03 Bratislava, Slovak Republic.
Atherosclerosis. 2018 Oct;277:355-361. doi: 10.1016/j.atherosclerosis.2018.08.008.
BACKGROUND AND AIMS: Despite the high prevalence of familial hypercholesterolemia (FH) and available effective lipid-lowering therapy, most of the individuals with this disorder remain undiagnosed and undertreated. The aim of the PLANET registry was to assess the real-life attainment of low-density lipoprotein cholesterol (LDL-C) therapeutic target level in patients with heterozygous FH, to characterize prescribed lipid-lowering therapy with assessment of its efficiency according to the attainment of the target LDL-C level, and to characterize cardiovascular events observed in this patient population again in relation to LDL-C target level attainment. METHODS: PLANET registry was designed as a non-interventional, retrospective, cross-sectional, multicentre disease registry for adult patients with heterozygous FH in the Czech Republic and Slovakia. RESULTS: Overall, 1755 patients were enrolled at 32 sites specialized in FH treatment. 15.4% of patients attained the target LDL-C value. The proportion of patients with LDL-C goal achievement increased to 17.3% in the subgroup of patients receiving high-intensity statin therapy (54.6% of study population). Out of 55 patients receiving inhibitors of proprotein convertase subtilisin/kexin type 9 (PCSK9), 61.8% reached the LDL-C treatment goal. Of all cardiovascular events reported, 14.0% occurred in patients attaining the LDL-C goal, while it was 86.0% in the not-at-target group. It was documented (p=0.004) that the longer is the patient in care at the specialized FH centre, the higher is the probability that he/she will attain the target LDL-C level. CONCLUSIONS: Although target LDL-C level attainment remains relatively low, the likelihood of LDL-C goal attainment increases with duration of specialized care.
背景与目的:尽管家族性高胆固醇血症(FH)的患病率很高,且有有效的降脂治疗方法,但大多数此类患者仍未被诊断和治疗不足。PLANET 登记研究旨在评估杂合子 FH 患者的低密度脂蛋白胆固醇(LDL-C)治疗目标水平的实际达标情况,根据 LDL-C 目标水平的达标情况来描述处方降脂治疗,并再次根据 LDL-C 目标水平的达标情况来描述该患者人群中观察到的心血管事件。
方法:PLANET 登记研究是一项非干预性、回顾性、横断面、多中心的疾病登记研究,纳入捷克共和国和斯洛伐克的成年杂合子 FH 患者。
结果:共有 32 个 FH 治疗专科中心的 1755 例患者入组。15.4%的患者达到了 LDL-C 目标值。在接受高强度他汀类药物治疗的患者亚组中(占研究人群的 54.6%),达到 LDL-C 目标值的患者比例增加至 17.3%。在接受前蛋白转化酶枯草溶菌素 9(PCSK9)抑制剂治疗的 55 例患者中,61.8%达到了 LDL-C 治疗目标。在报告的所有心血管事件中,14.0%发生在达到 LDL-C 目标值的患者中,而未达到目标值的患者中为 86.0%。研究记录(p=0.004),患者在 FH 专科中心的治疗时间越长,达到 LDL-C 目标值的可能性就越高。
结论:尽管 LDL-C 目标值达标率仍然相对较低,但随着专科治疗时间的延长,达到 LDL-C 目标值的可能性会增加。
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