BACKGROUND: In deciding on optimal interventions for cardiovascular disease (CVD) prevention, more than one set of guidelines are available. HYPOTHESIS: The aim of the study was to assess the agreement between the European Society of Cardiology (ESC) 2011 Guidelines for CVD Prevention and the Canadian Cardiovascular Society (CCS) 2009 Guidelines in recommending lipid lowering interventions in a seemingly healthy cohort of Lebanese persons. METHODS: A nationally representative cohort of Lebanon was identified according to the World Health Organization (WHO) Steps Criteria. From this cohort, a group of 283 adult individuals not known to have chronic illnesses was selected. Using the algorithms present in each guideline, lipid lowering recommendations for each individual were determined. Agreement between the two guideline recommendations was determined using the Kappa test. RESULTS: As per ESC, 3.9% of the participants required immediate drug therapy, 15.5% should be considered for drug therapy, and 80.1% required lifestyle intervention. As per the CCS, however, 19.4% required drug therapy. The overall level of agreement between the ESC and CCS for recommending lipid lowering was moderate (Kappa 0.77), and better in males (Kappa 0.82). In contrast, 37.5% of females recommended drug therapy as per the CCS guidelines would not be per the ESC guidelines (Kappa 0.63). CONCLUSIONS: Significant discrepancies exist in recommendations for lipid-lowering therapy between CCS and ESC guidelines when applied to Lebanese individuals, particularly for women. Local healthcare authorities and the WHO should attend to this issue in order to unify treatment approaches and limit disparities in care.
BACKGROUND: In deciding on optimal interventions for cardiovascular disease (CVD) prevention, more than one set of guidelines are available. HYPOTHESIS: The aim of the study was to assess the agreement between the European Society of Cardiology (ESC) 2011 Guidelines for CVD Prevention and the Canadian Cardiovascular Society (CCS) 2009 Guidelines in recommending lipid lowering interventions in a seemingly healthy cohort of Lebanese persons. METHODS: A nationally representative cohort of Lebanon was identified according to the World Health Organization (WHO) Steps Criteria. From this cohort, a group of 283 adult individuals not known to have chronic illnesses was selected. Using the algorithms present in each guideline, lipid lowering recommendations for each individual were determined. Agreement between the two guideline recommendations was determined using the Kappa test. RESULTS: As per ESC, 3.9% of the participants required immediate drug therapy, 15.5% should be considered for drug therapy, and 80.1% required lifestyle intervention. As per the CCS, however, 19.4% required drug therapy. The overall level of agreement between the ESC and CCS for recommending lipid lowering was moderate (Kappa 0.77), and better in males (Kappa 0.82). In contrast, 37.5% of females recommended drug therapy as per the CCS guidelines would not be per the ESC guidelines (Kappa 0.63). CONCLUSIONS: Significant discrepancies exist in recommendations for lipid-lowering therapy between CCS and ESC guidelines when applied to Lebanese individuals, particularly for women. Local healthcare authorities and the WHO should attend to this issue in order to unify treatment approaches and limit disparities in care.
Authors: Jacques Genest; Ruth McPherson; Jiri Frohlich; Todd Anderson; Norm Campbell; André Carpentier; Patrick Couture; Robert Dufour; George Fodor; Gordon A Francis; Steven Grover; Milan Gupta; Robert A Hegele; David C Lau; Lawrence Leiter; Gary F Lewis; Eva Lonn; G B John Mancini; Dominic Ng; Glen J Pearson; Allan Sniderman; James A Stone; Ehud Ur Journal: Can J Cardiol Date: 2009-10 Impact factor: 5.223
Authors: Joanne M Murabito; Michael J Pencina; Byung-Ho Nam; Ralph B D'Agostino; Thomas J Wang; Donald Lloyd-Jones; Peter W F Wilson; Christopher J O'Donnell Journal: JAMA Date: 2005-12-28 Impact factor: 56.272
Authors: Lori Mosca; Emelia J Benjamin; Kathy Berra; Judy L Bezanson; Rowena J Dolor; Donald M Lloyd-Jones; L Kristin Newby; Ileana L Piña; Véronique L Roger; Leslee J Shaw; Dong Zhao; Theresa M Beckie; Cheryl Bushnell; Jeanine D'Armiento; Penny M Kris-Etherton; Jing Fang; Theodore G Ganiats; Antoinette S Gomes; Clarisa R Gracia; Constance K Haan; Elizabeth A Jackson; Debra R Judelson; Ellie Kelepouris; Carl J Lavie; Anne Moore; Nancy A Nussmeier; Elizabeth Ofili; Suzanne Oparil; Pamela Ouyang; Vivian W Pinn; Katherine Sherif; Sidney C Smith; George Sopko; Nisha Chandra-Strobos; Elaine M Urbina; Viola Vaccarino; Nanette K Wenger Journal: Circulation Date: 2011-02-14 Impact factor: 29.690
Authors: Donald M Lloyd-Jones; Byung-Ho Nam; Ralph B D'Agostino; Daniel Levy; Joanne M Murabito; Thomas J Wang; Peter W F Wilson; Christopher J O'Donnell Journal: JAMA Date: 2004-05-12 Impact factor: 56.272
Authors: Ralph B D'Agostino; Ramachandran S Vasan; Michael J Pencina; Philip A Wolf; Mark Cobain; Joseph M Massaro; William B Kannel Journal: Circulation Date: 2008-01-22 Impact factor: 29.690
Authors: Joep Perk; Guy De Backer; Helmut Gohlke; Ian Graham; Zeljko Reiner; Monique Verschuren; Christian Albus; Pascale Benlian; Gudrun Boysen; Renata Cifkova; Christi Deaton; Shah Ebrahim; Miles Fisher; Giuseppe Germano; Richard Hobbs; Arno Hoes; Sehnaz Karadeniz; Alessandro Mezzani; Eva Prescott; Lars Ryden; Martin Scherer; Mikko Syvänne; Wilma J M Scholte op Reimer; Christiaan Vrints; David Wood; Jose Luis Zamorano; Faiez Zannad Journal: Eur Heart J Date: 2012-05-03 Impact factor: 29.983
Authors: Ana De Lorenzo-Pinto; Raquel García-Sánchez; Esther Durán-García; Ana Castuera-Gil; Cristina Pascual-Izquierdo; Belén Marzal-Alfaro; Paula Arrabal-Durán; Ana Herranz-Alonso; Juan A Andueza-Lillo; María Sanjurjo-Sáez Journal: Eur J Hosp Pharm Date: 2015-11-06