Citarella Anna, Cammarota Simona, Bernardi Francesca Futura, Caliendo Luigi, D'Andrea Antonello, Fimiani Biagio, Fogliasecca Marianna, Pacella Daniela, Pagnotta Rita, Trama Ugo, Zito Giovanni Battista, Cillo Mariarosaria, Vercellone Adriano
LinkHealth Health Economics, Outcomes & Epidemiology S.R.L., 80143 Naples, Italy.
Regional Pharmaceutical Unit, Campania Region, 80143 Naples, Italy.
J Clin Med. 2022 Jul 26;11(15):4344. doi: 10.3390/jcm11154344.
Current international guidelines strongly recommend the use of high-intensity lipid-lowering therapy (LLT) after hospitalization for atherosclerotic cardiovascular disease (ASCVD) events. With this study, our aim was to evaluate LLT prescribing in a large Italian cohort of patients after discharge for an ASCVD event, exploring factors associated with a lower likelihood of receiving any LLT and high-intensity LLT. Individuals aged 18 years and older discharged for an ASCVD event in 2019-2020 were identified using hospital discharge abstracts from two local health units of the Campania region. LLT treatment patterns were analyzed in the 6 months after the index event. Logistic regression models were developed for estimating patient predictors of any LLT prescription and to compare high-intensity and low-to-moderate-intensity LLT. Results: A total of 8705 subjects were identified. In the 6 months post-discharge, 56.7% of patients were prescribed LLT and, of those, 48.7% were high-intensity LLT. Female sex, older age, and stroke/TIA or PAD conditions were associated with a higher likelihood of not receiving high-intensity LLT. Similar predictors were found for LLT prescriptions. LLT utilization and the specific use of high-intensity LLT remain low in patients with ASCVD, suggesting a substantial unmet need among these patients in the contemporary real-world setting.
当前国际指南强烈推荐在因动脉粥样硬化性心血管疾病（ASCVD）事件住院后使用高强度降脂治疗（LLT）。通过本研究，我们的目的是评估意大利一大群因ASCVD事件出院的患者的LLT处方情况，探究与接受任何LLT及高强度LLT可能性较低相关的因素。利用坎帕尼亚地区两个当地卫生单位的医院出院摘要，确定了2019 - 2020年因ASCVD事件出院的18岁及以上个体。在索引事件后的6个月内分析LLT治疗模式。建立逻辑回归模型以估计任何LLT处方的患者预测因素，并比较高强度与低至中等强度LLT。结果：共识别出8705名受试者。出院后6个月内，56.7%的患者接受了LLT处方，其中48.7%接受高强度LLT。女性、年龄较大以及中风/短暂性脑缺血发作（TIA）或外周动脉疾病（PAD）情况与未接受高强度LLT的较高可能性相关。LLT处方也发现了类似的预测因素。ASCVD患者中LLT的使用率及高强度LLT的具体使用情况仍然较低，这表明在当代现实环境中这些患者存在大量未满足的需求。
