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根据风险组和性别差异,使用他汀类药物的患者对当前血脂异常指南的依从性:AIZANOI 研究。

Adherence to Current Dyslipidemia Guideline in Patients Utilizing Statins According to Risk Groups and Gender Differences: The AIZANOI Study.

机构信息

Department of Cardiology, Faculty of Medicine, Kütahya Health Sciences University, Kütahya, Türkiye.

Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Center, İstanbul, Türkiye.

出版信息

Anatol J Cardiol. 2024 Jun;28(6):273-282. doi: 10.14744/AnatolJCardiol.2024.4218.

Abstract

BACKGROUND

The aim of this study was to assess the adherence to the current European Society of Cardiology dyslipidemia guidelines, the ratio of reaching target values according to risk groups, and the reasons for not reaching LDL-cholesterol (LDL-C) goals in patients on already statin therapy in a cardiology outpatient population.

METHODS

The AIZANOI study is a multi-center, cross-sectional observational study including conducted in 9 cardiology centers between August 1, 2021, and November 1, 2021.

RESULTS

A total of 1225 patients (mean age 62 ± 11 years, 366 female) who were already on statin therapy for at least 3 months were included. More than half (58.2%) of the patients were using high-intensity statin regimens. Only 26.2% of patients had target LDL-C level according to their risk score. Despite 58.4% of very high-risk patients and 44.4% of high-risk patients have been using a high-intensity statin regimen, only 24.5% of very-high-risk patients and only 34.9% of high-risk patients have reached guideline-recommended LDL-C levels. Most prevalent reason for not using target dose statin was physician preference (physician inertia) (40.3%).

CONCLUSION

The AIZANOI study showed that we achieved a target LDL-C level in only 26.2% of patients using statin therapy. Although 58.4% of patients with a very high SCORE risk and 44.4% of patients with a high SCORE risk were using a target dose statin regimen, we were only able to achieve guideline-recommended LDL-C levels in 24.5% and 34.9% of them, respectively, in cardiology outpatients clinics. Physician inertia is one of the major factors in non-adherence to guidelines. These findings highlight that combination therapy is needed in most of the patients.

摘要

背景

本研究旨在评估心内科门诊患者在他汀类药物治疗基础上,对现行欧洲心脏病学会血脂异常指南的依从性、根据风险组别达到目标值的比例,以及未达到 LDL-胆固醇(LDL-C)目标的原因。

方法

AIZANOI 研究是一项多中心、横断面观察性研究,于 2021 年 8 月 1 日至 2021 年 11 月 1 日在 9 个心内科中心进行。

结果

共纳入 1225 例(平均年龄 62 ± 11 岁,366 例女性)他汀类药物治疗至少 3 个月的患者。超过一半(58.2%)的患者使用高强度他汀类药物治疗方案。仅有 26.2%的患者根据风险评分达到 LDL-C 目标值。尽管 58.4%的极高危患者和 44.4%的高危患者使用高强度他汀类药物治疗方案,但仅 24.5%的极高危患者和仅 34.9%的高危患者达到指南推荐的 LDL-C 水平。未使用目标剂量他汀类药物的最常见原因是医生的偏好(医生惯性)(40.3%)。

结论

AIZANOI 研究表明,我们仅在使用他汀类药物治疗的患者中使 26.2%的患者达到 LDL-C 目标值。尽管 58.4%的极高危 SCORE 风险患者和 44.4%的高危 SCORE 风险患者使用目标剂量他汀类药物治疗方案,但我们仅能使 24.5%和 34.9%的患者达到指南推荐的 LDL-C 水平,心内科门诊患者中医生惯性是不遵循指南的主要因素之一。这些发现强调,大多数患者需要联合治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/42be/11168716/d1abd8be3850/ajc-28-6-273_f001.jpg

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