Branislav Vohnout1, Ľubomíra Fábryová2, Alexander Klabník3, Michaela Kadurová4, Karin Bálinth5, Miriam Kozárová6, Ingrid Bugáňová7, Jana Sirotiaková5, Katarína Rašlová8. 1. Institute of Nutrition, Faculty of Nursing and Professional Health Studies, Slovak Medical University in Bratislava, Limbová 12, 833 01, Bratislava, Slovakia; Co-ordination Center for Familial Hyperlipidemias, Faculty of Public Health, Slovak Medical University in Bratislava, Slovakia. Electronic address: bvohnout@yahoo.com. 2. Metabolklinik Ltd, Bratislava, Slovakia. 3. Cardiology Clinic, Námestovo, Slovakia. 4. Lipid Clinic, Poprad, Slovakia. 5. Dept. of Internal Medicine, Hospital Levice, Slovakia. 6. IVthDept. of Internal Medicine, Medical Faculty, PJ Šafárik University, Košice, Slovakia. 7. Diabetes Clinic, MEDIVASA Ltd, Žilina, Slovakia. 8. Co-ordination Center for Familial Hyperlipidemias, Faculty of Public Health, Slovak Medical University in Bratislava, Slovakia.
Abstract
BACKGROUND AND AIMS: Maximal doses of potent statins are the cornerstone of treatment of familial hypercholesterolemia (FH). Despite this, a substantial proportion of FH patients are either under-treated or not treated at all. The aim of this work was to evaluate, in a retrospective study, the treatment of FH patients, the proportion of FH patients reaching low-density lipoprotein cholesterol (LDL-C) goals, and reasons for not reaching LDL-C goals, in 8 lipid clinics in Slovakia dealing with FH patients. METHODS: 201 heterozygous FH patients (50.8 ± 14.9 years, 55% females) who attended the lipid clinics at least three times were included in the study. RESULTS: At the first visit, 31.3% of patients were treated with statins and the most common dose was 20 mg of atorvastatin, rosuvastatin and simvastatin. At the third visit, 78.1% of patients were treated with statins and 24.4% with ezetimibe. The majority of patients were treated with atorvastatin (75.8%) and rosuvastatin (18.5%) and 31.3% of all patients were treated with atorvastatin 80 mg or rosuvastatin 40 mg with/without ezetimibe. However, only 11.9% of patients with the LDL-C goal level <2.5 mmol/l and 6.9% with the goal <1.8 mmol/l reached the level. Reasons for not reaching the goal levels were evaluated by physicians in each patient. Insufficient LDL-C lowering effect of treatment, side-effects of therapy and non-compliance of patients were responsible for 46%, 18% and 30% of cases, respectively. CONCLUSIONS: Referral of FH patients to lipid clinics in Slovakia leads to improvement in the treatment; however, almost 22% of the patients are still without statin treatment and the majority of patients do not reach the LDL-C goal level.
BACKGROUND AND AIMS: Maximal doses of potent statins are the cornerstone of treatment of familial hypercholesterolemia (FH). Despite this, a substantial proportion of FHpatients are either under-treated or not treated at all. The aim of this work was to evaluate, in a retrospective study, the treatment of FHpatients, the proportion of FHpatients reaching low-density lipoprotein cholesterol (LDL-C) goals, and reasons for not reaching LDL-C goals, in 8 lipid clinics in Slovakia dealing with FHpatients. METHODS: 201 heterozygous FHpatients (50.8 ± 14.9 years, 55% females) who attended the lipid clinics at least three times were included in the study. RESULTS: At the first visit, 31.3% of patients were treated with statins and the most common dose was 20 mg of atorvastatin, rosuvastatin and simvastatin. At the third visit, 78.1% of patients were treated with statins and 24.4% with ezetimibe. The majority of patients were treated with atorvastatin (75.8%) and rosuvastatin (18.5%) and 31.3% of all patients were treated with atorvastatin 80 mg or rosuvastatin 40 mg with/without ezetimibe. However, only 11.9% of patients with the LDL-C goal level <2.5 mmol/l and 6.9% with the goal <1.8 mmol/l reached the level. Reasons for not reaching the goal levels were evaluated by physicians in each patient. Insufficient LDL-C lowering effect of treatment, side-effects of therapy and non-compliance of patients were responsible for 46%, 18% and 30% of cases, respectively. CONCLUSIONS: Referral of FHpatients to lipid clinics in Slovakia leads to improvement in the treatment; however, almost 22% of the patients are still without statin treatment and the majority of patients do not reach the LDL-C goal level.