Department of Internal Medicine 2, Cardiology, Ordensklinikum Linz, Barmherzige Schwestern, Seilerstätte 4, 4010, Linz, Austria.
Diabetes & Metabolic Outpatient Clinic, Health Centre Favoriten, Vienna, Austria.
Wien Klin Wochenschr. 2022 Apr;134(7-8):294-301. doi: 10.1007/s00508-021-01978-w. Epub 2021 Dec 6.
Cardiovascular disease (CVD) is the most frequent cause of death in Austria. The European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guidelines recommend intensive lipid lowering therapy (LLT) in patients at high or very high CV risk. Lipid management and achievement of low-density lipoprotein cholesterol (LDL-C) goals in Austria have not recently been assessed.
Subgroup analysis for Austria of a European 18 country, cross-sectional, observational study. Patients received LLT for primary (PP) or secondary prevention (SP). Data including LLT in the preceding 12 months and most recent LDL‑C were collected during a single visit between June 2017 and November 2018. Achievement of the risk-based 2016 and 2019 ESC/EAS LDL‑C goal while receiving stabilized LLT was assessed.
A total of 293 patients were enrolled from 8 Austrian sites, of which 200 (PP = 104, SP = 96) received stabilized LLT at the LDL‑C measurement date. Overall, 58% (71% PP, 43% SP) and 38% (52% PP, 23% SP) achieved the risk-based 2016 and 2019 goals, respectively. Most patients received moderate-intensity statin monotherapy (46%), while 34% used high-intensity statin monotherapy. Combination therapy of moderate/high-intensity statin with ezetimibe (12%), or proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors with statin ± ezetimibe (1%), was used infrequently.
The current Austrian routine lipid management using mainly moderate-intensity or high-intensity statin monotherapy is insufficient to attain ESC/EAS guideline goals, in particular the more stringent 2019 recommendations, a situation comparable to other participating European countries. In addition to switching to and optimizing doses of high-intensity statins, a combination with ezetimibe or PCSK9 inhibitors will be needed in many cases.
心血管疾病（CVD）是奥地利最常见的死亡原因。欧洲心脏病学会（ESC）/欧洲动脉粥样硬化学会（EAS）指南建议对高或极高心血管风险的患者进行强化降脂治疗（LLT）。最近并未评估奥地利的血脂管理和低密度脂蛋白胆固醇（LDL-C）目标达标情况。
这是一项在 18 个欧洲国家进行的、基于人群的、横断面、观察性研究的奥地利亚组分析。患者接受用于一级（PP）或二级（SP）预防的 LLT。在 2017 年 6 月至 2018 年 11 月期间的单次就诊期间收集了包括过去 12 个月 LLT 和最近 LDL-C 在内的数据。评估在接受稳定的 LLT 治疗时，基于风险的 2016 年和 2019 年 ESC/EAS LDL-C 目标的达标情况。
从 8 个奥地利站点共纳入 293 例患者，其中 200 例（PP=104 例，SP=96 例）在 LDL-C 测量日期接受了稳定的 LLT。总体而言，分别有 58%（PP 为 71%，SP 为 43%）和 38%（PP 为 52%，SP 为 23%）达到了基于风险的 2016 年和 2019 年目标。大多数患者接受中等强度他汀单药治疗（46%），而 34%的患者接受高强度他汀单药治疗。中等/高强度他汀联合依折麦布（12%）或前蛋白转化酶枯草溶菌素 9（PCSK9）抑制剂联合他汀±依折麦布（1%）的联合治疗应用较少。
目前奥地利使用主要为中等强度或高强度他汀单药治疗的常规血脂管理方案，无法达到 ESC/EAS 指南目标，特别是更为严格的 2019 年推荐，这一情况与其他参与的欧洲国家相似。除了转换并优化高强度他汀的剂量外，在许多情况下还需要联合依折麦布或 PCSK9 抑制剂。
