Urbonas Gediminas, Lapinskas Tomas, Čeponienė Indrė, Vasiliauskienė Olga, Umbrasienė Jelena, Grabauskytė Ingrida, Plisienė Jurgita
Department of Family Medicine, Medical Academy, Lithuanian University of Health Sciences, Eivenių 2, 50161 Kaunas, Lithuania.
Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Eivenių 2, 50161 Kaunas, Lithuania.
Medicina (Kaunas). 2025 Aug 19;61(8):1484. doi: 10.3390/medicina61081484.
: Low-density lipoprotein cholesterol (LDL-C) reduction is critical for cardiovascular disease (CVD) prevention. This study aimed to assess the proportion of patients achieving the LDL-C target in Lithuania and to identify factors associated with target achievement. : This retrospective study used anonymized health data from the Electronic Health Services and Cooperation Infrastructure Information System (ESPBI IS) in Lithuania. Adults aged ≥40 years with at least one LDL-C measurement in 2023 and no documented cancer diagnosis were included. The primary outcome was the proportion of patients achieving LDL-C < 1.8 mmol/L, the target recommended by the European Society of Cardiology guidelines for high-risk individuals. Univariate logistic regression analysis was conducted to identify factors associated with achieving the LDL-C target. : The study included 396,835 patients (mean age, 66.9 years). The mean LDL-C concentration was 3.32 mmol/L, and only 8.1% of patients achieved LDL-C < 1.8 mmol/L. Target achievement was higher among patients in the secondary CVD prevention group compared to primary prevention (20.6% vs. 7.3%). Over half of patients (56.4%) received no lipid-lowering therapy (LLT). Statin monotherapy was the most prescribed LLT (31.3%), while only 2.7% of patients received statin and ezetimibe combination. In logistic regression analysis, secondary prevention status, more frequent cardiologist consultations, and higher LLT prescription frequency were associated with LDL-C target achievement. Compared to patients not receiving LLT, the odds of achieving LDL-C < 1.8 mmol/L were significantly higher in those receiving statin monotherapy (odds ratio [OR]: 3.153, 95% confidence interval [CI]: 3.069-3.240), statin and ezetimibe (OR: 7.631, 95% CI: 7.267-8.013), or statin and antihypertensive (OR: 3.945, 95% CI: 3.803-4.092). : LDL-C target attainment remains low in Lithuania, with the underuse of LLT. Broader implementation of guideline-recommended lipid-lowering strategies is needed to improve LDL-C control.
降低低密度脂蛋白胆固醇（LDL-C）对预防心血管疾病（CVD）至关重要。本研究旨在评估立陶宛达到LDL-C目标的患者比例，并确定与目标达成相关的因素。：这项回顾性研究使用了立陶宛电子健康服务与合作基础设施信息系统（ESPBI IS）的匿名健康数据。纳入了2023年至少有一次LDL-C测量值且无癌症诊断记录的≥40岁成年人。主要结局是达到LDL-C<1.8 mmol/L的患者比例，这是欧洲心脏病学会指南为高危个体推荐的目标。进行单因素逻辑回归分析以确定与达到LDL-C目标相关的因素。：该研究纳入了396,835名患者（平均年龄66.9岁）。平均LDL-C浓度为3.32 mmol/L，只有8.1%的患者达到LDL-C<1.8 mmol/L。与一级预防患者相比，二级CVD预防组患者的目标达成率更高（20.6%对7.3%）。超过一半的患者（56.4%）未接受降脂治疗（LLT）。他汀类单药治疗是最常用的LLT（31.3%），而只有2.7%的患者接受他汀类与依泽替米贝联合治疗。在逻辑回归分析中，二级预防状态、更频繁的心脏病专家会诊以及更高的LLT处方频率与LDL-C目标达成相关。与未接受LLT的患者相比，接受他汀类单药治疗（优势比[OR]：3.153，95%置信区间[CI]：3.069 - 3.240）、他汀类与依泽替米贝联合治疗（OR：7.631，95% CI：7.267 - 8.013）或他汀类与抗高血压药物联合治疗（OR：3.945，95% CI：3.803 - 4.092）的患者达到LDL-C<1.8 mmol/L的几率显著更高。：立陶宛的LDL-C目标达成率仍然很低，LLT使用不足。需要更广泛地实施指南推荐的降脂策略以改善LDL-C控制。
