Klinik Für Innere Medizin I, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany.
Cholesterin & Co E. V.: Patientenorganisation Für Patienten Mit Familiärer Hypercholesterinämie Oder Anderen Schweren Genetischen Fettstoffwechselstörungen (CholCo), Frankfurt/M., Germany.
Adv Ther. 2023 Feb;40(2):460-473. doi: 10.1007/s12325-022-02357-1. Epub 2022 Nov 10.
Low-density lipoprotein cholesterol (LDL-C) reduction in hypercholesterolemia patients at very high cardiovascular (CV) risk is essential in preventing future CV events. The objective was to assess the perception on hypercholesterolemia management in secondary prevention in Germany.
PROCYON was a two-part online survey, including a patient questionnaire as well as a physician questionnaire.
A total of 109 general practitioners, internists, and cardiologists participated. The current ESC/EAS recommendation for high-risk patients is followed by 19.3% of the physicians. The majority (80.7%) reported an LDL-C target failure rate of at least 30%. More than two thirds (71.6%) have stated treating less than half of their patients with the maximum approved statin dose. The survey included 1696 secondary prevention patients. The majority (86.7%) consult their general practitioner for hypercholesterolemia; 54.0% consult a cardiologist (multiple answers allowed). Most patients (87.0%) were receiving lipid-lowering medication. Among these, 800 (54.2%) reported improved LDL-C levels since diagnosis, 569 (38.6%) reported no improvement, and 106 (7.2%) had no information. Of the treated patients with (N' = 800) and without (N' = 569) improvement, 34.3% vs. 37.3% were on their initial drug and dose, 24.8% vs. 23.7% received multiple drug therapy, 48.9% vs. 48.9% reported a dose change, and 16.1% vs. 14.2% had discontinued at least one drug (multiple answers). Disease knowledge was rated as good or very good by 29.8% of patients.
PROCYON demonstrated insufficient ESC/EAS guideline implementation regarding target levels and therapeutic escalation strategies. Furthermore, a lack of specialist involvement and patient education was identified.
极高心血管风险的高胆固醇血症患者降低低密度脂蛋白胆固醇（LDL-C）对于预防未来心血管事件至关重要。本研究旨在评估德国二级预防中对高胆固醇血症管理的认知。
PROCYON 是一项两部分的在线调查，包括患者问卷和医生问卷。
共有 109 名全科医生、内科医生和心脏病专家参与了该研究。19.3%的医生遵循目前 ESC/EAS 高风险患者的建议。大多数（80.7%）报告 LDL-C 目标失败率至少为 30%。超过三分之二（71.6%）的医生表示，他们对不到一半的患者使用了最大批准的他汀剂量。该调查纳入了 1696 名二级预防患者。大多数（86.7%）会因高胆固醇血症咨询全科医生；54.0%咨询心脏病专家（可多项选择）。大多数患者（87.0%）正在服用降脂药物。在这些患者中，800 名（54.2%）报告自诊断以来 LDL-C 水平得到改善，569 名（38.6%）报告无改善，106 名（7.2%）无相关信息。在接受治疗的有改善（N' = 800）和无改善（N' = 569）的患者中，34.3%和 37.3%分别处于初始药物和剂量，24.8%和 23.7%分别接受了多种药物治疗，48.9%和 48.9%分别报告了剂量调整，16.1%和 14.2%分别至少停用了一种药物（可多项选择）。29.8%的患者认为自己的疾病知识良好或非常好。
PROCYON 研究表明，在目标水平和治疗升级策略方面，ESC/EAS 指南的实施情况并不理想。此外，还发现缺乏专家参与和患者教育。
