Virani Salim S, Aspry Karen, Dixon Dave L, Ferdinand Keith C, Heidenreich Paul A, Jackson Elizabeth J, Jacobson Terry A, McAlister Janice L, Neff David R, Gulati Martha, Ballantyne Christie M
Baylor College of Medicine, Houston, Texas, USA (Drs Virani, Ballantyne); Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA (Dr Virani); The Aga Khan University, Karachi, Pakistan (Dr Virani).
Lifespan Cardiovascular Institute, and Alpert Medical School, Brown University, Providence, Rhode Island, USA (Dr Aspry).
J Clin Lipidol. 2023 Mar-Apr;17(2):208-218. doi: 10.1016/j.jacl.2023.02.003. Epub 2023 Feb 27.
Despite the established role of low-density lipoprotein cholesterol (LDL-C) as a major risk factor for cardiovascular disease (CVD), and the persistence of CVD as the leading cause of morbidity and mortality in the United States, national quality assurance metrics no longer include LDL-C measurement as a required performance metric. This clinical perspective reviews the history of LDL-C as a quality and performance metric and the events that led to its replacement. It also presents patient, healthcare provider, and health system rationales for re-establishing LDL-C measurement as a performance measure to improve cholesterol control in high-risk groups and to stem the rising tide of CVD morbidity and mortality, cardiovascular care disparities, and related healthcare costs.
尽管低密度脂蛋白胆固醇(LDL-C)作为心血管疾病(CVD)的主要危险因素已被确立,且在美国CVD持续作为发病和死亡的主要原因,但国家质量保证指标不再将LDL-C测量作为必需的性能指标。本临床观点回顾了LDL-C作为质量和性能指标的历史以及导致其被取代的事件。它还阐述了将LDL-C测量重新确立为性能指标的患者、医疗服务提供者和卫生系统的理由,以改善高危人群的胆固醇控制,并遏制CVD发病率和死亡率上升、心血管护理差异以及相关医疗费用上涨的趋势。