Low LDL-C goal attainment in patients at very high cardiovascular risk due to lacking observance of the guidelines on dyslipidaemias

VRABLIK, Michal, Ivana SARKANOVA, Katarina BRECIKOVA, Petra ŠEDOVÁ, Martin SATNY and Ales TICHOPAD. Low LDL-C goal attainment in patients at very high cardiovascular risk due to lacking observance of the guidelines on dyslipidaemias. Plos one. San Francisco: Public Library of Science, 2023, vol. 18, No 5, p. 1-14. ISSN 1932-6203. Available from: https://dx.doi.org/10.1371/journal.pone.0272883.

Basic information

• Original name: Low LDL-C goal attainment in patients at very high cardiovascular risk due to lacking observance of the guidelines on dyslipidaemias
• Authors: VRABLIK, Michal (203 Czech Republic), Ivana SARKANOVA (203 Czech Republic), Katarina BRECIKOVA (203 Czech Republic), Petra ŠEDOVÁ (203 Czech Republic, belonging to the institution), Martin SATNY (203 Czech Republic) and Ales TICHOPAD (203 Czech Republic, guarantor).
• Edition: Plos one, San Francisco, Public Library of Science, 2023, 1932-6203.

Other information

• Original language: English
• Type of outcome: Article in a journal
• Field of Study: 30201 Cardiac and Cardiovascular systems
• Country of publisher: United States of America
• Confidentiality degree: is not subject to a state or trade secret
• WWW: URL
• Impact factor: Impact factor: 3.700 in 2022
• RIV identification code: RIV/00216224:14110/23:00131863
• Organization unit: Faculty of Medicine
• Doi: http://dx.doi.org/10.1371/journal.pone.0272883
• UT WoS: 000993736200030
• Keywords in English: LDL-C; cardiovascular risk; dyslipidaemias
• Tags: 14110211, rivok
• Tags: International impact, Reviewed

Abstract

Dyslipidemias are defined as a wide range of abnormalities of the lipid profile. Treatment guidelines recommend aiming at lowering LDL-C. We investigated the adherence of Czech cardiologists to the dyslipidaemia treatment guidelines, especially in the management of patients with high and very high cardiovascular risk. In this retrospective cross-sectional multicentric study data from medical records of 450 adults with ASCVD, enrolled between June 2021 and January 2022, were analysed. Demographics, clinical outcomes, medical history, LLT treatment and other medications were collected. The physicians were to include patients at a very high risk of ASCVD and to complete a general questionnaire on their personal therapeutic preferences. Objectively assessed, only 80% of total patients (N = 450) enrolled in the study were at very high risk of ASCVD, and 12.7% of patients were at high risk of ASCVD, respectively. In total, 55 (13.1%) patients were diagnosed with familial hypercholesterolemia, and 39.1% of them had a positive family history of ASCVD. Generally, only 20.5% of patients reached the 2019 LDL-C goals- 19.4% of very high risk patients and 28.1% of high risk patients, respectively. 61% of the physicians preferred a slow and careful up-titration of the dose, which is contradictory to the guidelines. Only 17% of the physicians increased the statin dose or added/combined/changed the treatment to achieve the LDL-C goals as soon as possible. Surprisingly, in up to 61.5% of patients at very high risk who did not meet the LDL-C goals, their physicians stated subjective satisfaction with the treatment and considered no change needed. Among very high and high risk patients receiving lipid-lowering therapy, with high treatment adherence, the LDL-C goal attainment is very low and LLT utilization is rather sub-optimal. Improving observance of the guidelines by physicians bears a substantial potential for LDL-C goal attainment and thus improving overall benefit for patients for no additional costs.