ArticleLipids in health and disease2013
First-line treatment patterns and lipid target levels attainment in very high cardiovascular risk outpatients.
Article in Lipids in health and disease, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed, 12 citations in OpenAlex.
- Efficacy and safety of alirocumab, a fully human PCSK9 monoclonal antibody, in high cardiovascular risk patients with poorly controlled hypercholesterolemia on maximally tolerated doses of statins: rationale and design of the ODYSSEY COMBO I and II trials.BMC cardiovascular disorders · 2014Trial
- Sex Difference in Control of Low-Density Lipoprotein Cholesterol in Older Patients after Acute Coronary Syndrome.Geriatrics (Basel, Switzerland) · 2022Article
- Attainment of cholesterol target values in Greece: results from the Dyslipidemia International Study II.Archives of medical science : AMS · 2019Article
- Ezetimibe prescriptions in older Canadian adults after an acute myocardial infarction: a population-based cohort study.Lipids in health and disease · 2018Article
- Management of atherosclerosis risk factors for patients at high cardiovascular risk in real-world practice: a multicentre study.Singapore medical journal · 2017Article
- Statin prescription strategies and atherogenic cholesterol goals attainment in Lebanese coronary artery disease patients.International journal of clinical pharmacy · 2017Article
- Low-density lipoprotein cholesterol of less than 70 mg/dL is associated with fewer cardiovascular events in acute coronary syndrome patients: a real-life cohort in Thailand.Therapeutics and clinical risk management · 2015Article
- Statin therapy in patients with acute coronary syndrome: low-density lipoprotein cholesterol goal attainment and effect of statin potency.Therapeutics and clinical risk management · 2015Article
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Authors and funding
6 authors at 1 institution in 1 country.
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Abstract
objectivesPrevious studies have demonstrated gaps in achievement of low-density lipoprotein-cholesterol (LDL-C) goals among patients at very high cardiovascular risk. We aimed to investigate lipid treatment patterns, rates and predictors of lipid targets attainment, in such outpatients in an urban area of Greece.
methodsThis was a prospective observational study, conducted in 19 outpatient clinics of Western Greece. We recruited patients with established cardiovascular disease (CVD) and/or diabetes mellitus (DM), previously (at least 3 months before baseline assessment) untreated with any lipid lowering medication. Lipid profile assessment was performed at baseline (prior to lipid-lowering treatment initiation) and at follow-up. Lipid lowering treatment choice was at physicians' discretion and was kept constant until follow-up.
resultsWe recruited 712 patients with a mean age 61.4 ± 10.4 years, 68.0% males, 43.0% with DM, 64.7% with prior coronary artery disease-CAD. In total, 237/712 (33.3%) of prescribed regimens were of high or very high LDL-C lowering efficacy and out of them 113/237 (47.7%) comprised a combination of statin and ezetimibe. At follow-up the primary target of LDL-C < 70 mg/dL (1.8 mmol/L) was achieved in 71(10.0%) patients. The secondary target of non-HDL-C < 100 mg/dL (2.6 mmol/L) in the subgroup of patients with DM or increased triglycerides levels (>150 mg/dl or 1.7 mmol/L) was achieved in 45(11.6%) of patients. In multivariate logistic regression analysis (AUC = 0.71, 95% CIs 0.65-0.77, p < 0.001) male gender, smoking, baseline LDL-C and very high potency LDL-C lowering regimen emerged as independent predictors of LDL-C goal attainment (OR = 1.88, 95% CIs 1.03-3.44, p = 0.04, OR = 0.57, 95% CIs 0.33-0.96, p = 0.04, OR = 0.98, 95% CIs 0.98-0.99, p < 0.001 and OR = 2.21, 95% CIs 1.15-4.24, p = 0.02 respectively).
conclusionsFirst-line management of dyslipidemia among very-high cardiovascular risk outpatients in Western Greece is unsatisfactory, with the majority of treated individuals failing to attain the LDL-C and non-HDL-C targets. This finding points out the need for intensification of statin treatment in such patients.
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