Bello-Chavolla Omar Y, Aguilar-Salinas Carlos A
Metabolic Diseases Research Unit, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Combined Studies Program in Medicine MD/PhD (PECEM), Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico.
Rev Invest Clin. 2019;71(6):408-416. doi: 10.24875/RIC.19003156.
The International Cholesterol Management Practice Study is a multinational collaborative effort to describe the effectiveness of the lipid-lowering therapy (LLT) as well as the main barriers to achieve the low-density lipoprotein cholesterol (LDL-C) goals.
The objective of the study was to investigate factors associated with the achievement of LDL-C goals in Mexico using real-life data.
This was a cross-sectional observational study from 18 physicians across different health facilities in Mexico, who provided information about their practices between August 2015 and August 2016. We included patients treated for ≥3 months with any LLT in whom LDL-C measurement on stable LLT was available for the previous 12 months.
We included 623 patients with a mean age of 59.3 ± 12.7 years; 55.6% were women. The mean LDL-C value on LLT was 141.8 ± 56.1 mg/dL. At enrollment, 97.4% of patients were receiving statin therapy (11.3% on high-intensity treatment). Only 24.8% of the very-high cardiovascular (CV) risk patients versus 26.4% of the high risk and 52.4% of the moderate risk patients achieved their LDL-C goals. Independent factors associated with non-achievement of LDL-C goal were statin intolerance, overweight and obesity, abdominal obesity, female sex, high CV risk, use of public health-care service, metabolic syndrome, type 2 diabetes, and hypertriglyceridemia. Higher-level of education was associated with a lower risk of not achieving LDL-C goals.
Achievement of LDL-C goals is suboptimal in Mexico, especially in patients with the highest CV risk. The main barriers to achieve the goal are easily detectable. Implementation of LLT should be adapted to the patient's needs and profile.
国际胆固醇管理实践研究是一项跨国合作项目，旨在描述降脂治疗（LLT）的有效性以及实现低密度脂蛋白胆固醇（LDL-C）目标的主要障碍。
本研究的目的是利用实际数据调查墨西哥实现LDL-C目标的相关因素。
这是一项横断面观察性研究，来自墨西哥不同医疗机构的18名医生参与其中，他们提供了2015年8月至2016年8月期间其诊疗实践的信息。我们纳入了接受任何LLT治疗≥3个月且在过去12个月内有稳定LLT时LDL-C测量值的患者。
我们纳入了623例患者，平均年龄为59.3±12.7岁；55.6%为女性。LLT治疗时的平均LDL-C值为141.8±56.1mg/dL。入组时，97.4%的患者接受他汀类药物治疗（11.3%接受高强度治疗）。极高心血管（CV）风险患者中只有24.8%实现了LDL-C目标，而高风险患者为26.4%，中度风险患者为52.4%。与未实现LDL-C目标相关的独立因素包括他汀类药物不耐受、超重和肥胖、腹型肥胖、女性、高CV风险、使用公共医疗服务、代谢综合征、2型糖尿病和高甘油三酯血症。受教育程度较高与未实现LDL-C目标的风险较低相关。
在墨西哥，LDL-C目标的实现情况不理想，尤其是在CV风险最高的患者中。实现目标的主要障碍易于察觉。LLT的实施应根据患者的需求和情况进行调整。
