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

J 2023

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 et. al.

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

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

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

Abstract

V originále

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.

Citovat

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.

@article{2322823,
   author = {Vrablik, Michal and Sarkanova, Ivana and Brecikova, Katarina and Šedová, Petra and Satny, Martin and Tichopad, Ales},
   article_location = {San Francisco},
   article_number = {5},
   doi = {http://dx.doi.org/10.1371/journal.pone.0272883},
   keywords = {LDL-C; cardiovascular risk; dyslipidaemias},
   language = {eng},
   issn = {1932-6203},
   journal = {Plos one},
   title = {Low LDL-C goal attainment in patients at very high cardiovascular risk due to lacking observance of the guidelines on dyslipidaemias},
   url = {https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0272883},
   volume = {18},
   year = {2023}
}

TY  - JOUR
ID  - 2322823
AU  - Vrablik, Michal - Sarkanova, Ivana - Brecikova, Katarina - Šedová, Petra - Satny, Martin - Tichopad, Ales
PY  - 2023
TI  - Low LDL-C goal attainment in patients at very high cardiovascular risk due to lacking observance of the guidelines on dyslipidaemias
JF  - Plos one
VL  - 18
IS  - 5
SP  - 1-14
EP  - 1-14
PB  - Public Library of Science
SN  - 19326203
KW  - LDL-C
KW  - cardiovascular risk
KW  - dyslipidaemias
UR  - https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0272883
N2  - 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.
ER  -

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. \textit{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.

Detailed Information on Publication Record