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南非低密度脂蛋白胆固醇水平的管理:国际胆固醇管理实践研究(ICLPS)

Management of low-density lipoprotein cholesterol levels in South Africa: the International ChoLesterol management Practice Study (ICLPS).

作者信息

Blom Dirk J, Raal Frederick, Amod Aslam, Naidoo Poobalan, Lai Yen-Yu Evelyn

机构信息

Department of Medicine, Division of Lipidology and Hatter Institute for Cardiovascular Research in Africa, University of Cape Town, Cape Town, South Africa. Email:

Carbohydrate and Lipid Metabolism Research Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.

出版信息

Cardiovasc J Afr. 2019;30(1):15-23. doi: 10.5830/CVJA-2018-054. Epub 2019 Jan 16.

Abstract

The International Cholesterol Management Practice Study (ICLPS) South Africa investigated achievement of European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guideline low-density lipoprotein cholesterol (LDL-C) targets in real-world clinical practice. Demographic data, clinical characteristics, cardiovascular risk factors, lipid-modifying medications, lipid values and investigator's assessment of cardiovascular risk were recorded for 396 patients on stable lipid-modifying therapy. Most (98.7%) patients received statins; 25.1% of statin-treated patients were receiving high-intensity statins. Overall, 41.4% of patients achieved their LDL-C target; among 354 (89.4%) patients in whom cardiovascular disease risk, based on ESC Systematic Coronary Risk Estimation (SCORE) was calculated, achievement rate was 14.3% for moderate-risk (n = 7), 59.3% for high-risk (n = 123) and 32.3% for very high-risk patients (n = 223). Half of Asian (54.7%) and black African (53.2%) patients were at LDL-C target compared with 29.8% of European/Caucasian and 27.3% of 'other' patients. Improved guideline adherence and greater use of combination therapy may increase LDL-C goal achievement.

摘要

国际胆固醇管理实践研究(ICLPS)南非项目调查了在实际临床实践中欧洲心脏病学会(ESC)/欧洲动脉粥样硬化学会(EAS)指南中低密度脂蛋白胆固醇(LDL-C)目标的达成情况。记录了396例接受稳定调脂治疗患者的人口统计学数据、临床特征、心血管危险因素、调脂药物、血脂值以及研究者对心血管风险的评估。大多数(98.7%)患者接受他汀类药物治疗;25.1%接受他汀治疗的患者使用高强度他汀类药物。总体而言,41.4%的患者达到了LDL-C目标;在根据ESC系统性冠状动脉风险评估(SCORE)计算了心血管疾病风险的354例(89.4%)患者中,中度风险(n = 7)患者的达标率为14.3%,高风险(n = 123)患者为59.3%,极高风险患者(n = 223)为32.3%。亚洲患者(54.7%)和非洲黑人患者(53.2%)中有一半达到了LDL-C目标,而欧洲/高加索患者和“其他”患者的这一比例分别为29.8%和27.3%。提高指南依从性和更多地使用联合治疗可能会提高LDL-C目标达成率。

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