Weingärtner Oliver, Glück Simon, Werdan Karl, Schorr Jessica, Thieme Daniel, de la Llave Ana, von Vultée Christian, Haerer Winfried
Department of Internal Medicine I, Division of Cardiology, Angiology and Intensive Medical Care, Friedrich Schiller University, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany.
Center for Health Services Research of the German Cardiac Society (DGK-ZfKVF), German Cardiac Society, Duesseldorf, Germany.
Clin Res Cardiol. 2025 Aug 28. doi: 10.1007/s00392-025-02751-z.
Office-based cardiologists (OBCs) and general practitioners (GPs) follow different approaches for hypercholesterolemia management in atherosclerotic cardiovascular disease (ASCVD). This study evaluates whether differences in clinical practice between OBCs and GPs contribute to existing gaps in low-density lipoprotein cholesterol (LDL-C) control and lipoprotein(a) [Lp(a)] screening in ASCVD care.
LipidSnapshot is a collaborative research initiative comprising a prospective non-interventional study at OBCs and a retrospective analysis of GP records. It evaluates LDL-C target attainment, Lp(a) testing, and lipid-lowering therapies (LLT) in the OBC and the GP setting. Subgroup analyses by gender and age are conducted.
The dataset comprises 1,500 ASCVD patients from OBCs and 82,375 patients from GPs. The median LDL-C levels were 68 mg/dL (OBC) vs. 88 mg/dL (GP). LDL-C targets < 55 mg/dL were achieved in 27.4% of patients (OBC) vs. 12.1% of patients (GP). Lp(a) testing rate was 20.3% (OBC) vs. 3.0% (GP). The proportion of patients not receiving any LLT was 1.5% (OBC) vs. 26.6% (GP). LDL-C levels were numerically higher in female patients as well as in younger patients especially in the GP setting. Female patients were less likely to receive LLT compared to their male counterparts and half of the GP patients < 50 years of age remained untreated at all.
A large proportion of ASCVD patients in Germany are inadequately treated, with notable differences between GPs and OBCs. Additionally, gender and age-related disparities are evident. There is a clear need for these gaps to be addressed to improve cross-sectional patient care.
在动脉粥样硬化性心血管疾病（ASCVD）中，基层心脏病专家（OBC）和全科医生（GP）对高胆固醇血症的管理采用不同方法。本研究评估OBC和GP在临床实践上的差异是否导致了ASCVD护理中低密度脂蛋白胆固醇（LDL-C）控制和脂蛋白（a）[Lp（a）]筛查方面存在的差距。
脂质快照是一项合作研究计划，包括在OBC开展的前瞻性非干预性研究以及对GP记录的回顾性分析。它评估了OBC和GP环境下LDL-C目标达成情况、Lp（a）检测以及降脂治疗（LLT）。按性别和年龄进行亚组分析。
数据集包括来自OBC的1500例ASCVD患者和来自GP的82375例患者。LDL-C中位数水平在OBC为68mg/dL，在GP为88mg/dL。LDL-C目标<55mg/dL在27.4%的患者中实现（OBC），在12.1%的患者中实现（GP）。Lp（a）检测率为20.3%（OBC），3.0%（GP）。未接受任何LLT的患者比例为1.5%（OBC），26.6%（GP）。女性患者以及年轻患者的LDL-C水平在数值上更高，尤其是在GP环境中。与男性患者相比，女性患者接受LLT的可能性较小，并且在GP中，一半年龄<50岁的患者根本未接受治疗。
德国很大一部分ASCVD患者治疗不充分，GP和OBC之间存在显著差异。此外，性别和年龄相关的差异也很明显。显然需要解决这些差距以改善横断面患者护理。
