Kausik K Ray1, Bart Molemans2, W Marieke Schoonen3, Periklis Giovas4, Sarah Bray5, Gaia Kiru6, Jennifer Murphy6, Maciej Banach7,8,9, Stefano De Servi10, Dan Gaita11, Ioanna Gouni-Berthold12, G Kees Hovingh13, Jacek J Jozwiak14, J Wouter Jukema15, Robert Gabor Kiss16, Serge Kownator17, Helle K Iversen18,19, Vincent Maher20,21, Luis Masana22, Alexander Parkhomenko23, André Peeters24, Piers Clifford25, Katarina Raslova26, Peter Siostrzonek27, Stefano Romeo28,29,30, Dimitrios Tousoulis31, Charalambos Vlachopoulos31, Michal Vrablik32, Alberico L Catapano33, Neil R Poulter6. 1. Imperial Centre for Cardiovascular Disease Prevention and Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK. 2. Amgen Inc., 1 Amgen Center Drive, Thousand Oaks, CA 91320, USA. 3. Center for Observational Research (CfOR), Amgen Ltd, 1 Uxbridge Business Park Sanderson Road, Uxbridge, UB8 1DH, UK. 4. Amgen Hellas, 4 Gravias Street, Maroussi, 15125, Athens, Greece. 5. Global Biostatistical Science, Amgen Ltd, 240 Cambridge Science Park, Milton Road, Cambridge, CB4 0WD, UK. 6. Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK. 7. Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, 90-419 Lodz, Poland. 8. Polish Mother's Memorial Hospital - Research Institute (PMMHRI), 93-338 Lodz, Poland. 9. Cardiovascular Research Centre, University of Zielona Góra, 65-417 Zielona Góra, Poland. 10. IRCCS MultiMedica, Via Milanese, 300, 20099 Sesto San Giovanni, Milan, Italy. 11. Institutul de Boli Cardiovasculare, Fundatia Cardioprevent, Universitatea de Medicina si Farmacie Victor Babes din Timisoara, Timişoara 300041, Romania. 12. Polyclinic for Endocrinology, Diabetes and Preventive Medicine, Kerpener Str. 62, 50937 Cologne, Germany. 13. University of Amsterdam Faculty of Medicine, Amsterdam, the Netherlands. 14. Department of Family Medicine and Public Health, Faculty of Medicine, University of Opole, Opole, Poland. 15. Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, Netherlands. 16. Hungarian Army Medical Center, Budapest, 1134, Hungary. 17. Centre Cardiologique et Vasculaire, 36 Route de la Briquerie, 57100, Thionville, France. 18. Stroke Centre Rigshospitalet, Department of Neurology, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark. 19. Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. 20. Trinity College Dublin, Dublin 2, Ireland. 21. Advanced Lipid Management and Research Centre, Tallaght University Hospital, Dublin 24, Ireland. 22. Universitat Rovira i Virgili, IISPV, CIBERDEM, Saint Joan University Hospital, Reus, Spain. 23. Emergency Cardiology Department, Institute of Cardiology, Kiev, Ukraine. 24. Cliniques Universitaires Saint Luc, Avenue Hippocrate 10, 1200, Brussels, Belgium. 25. Imperial Hospitals NHS Trust (Hammersmith Campus), London W12 0HS, UK. 26. Slovak Medical University, 831 01 Bratislava, Slovakia. 27. Krankenhaus Barmherzige Schwestern Linz, Seilerstðtte 4, 4010 Seilerstätte 4, 4010 Linz, Austria. 28. Department of Molecular and Clinical Medicine, University of Gothenburg, 405 30 Gothenburg, Sweden. 29. Clinical Nutrition, Department of Medical and Surgical Sciences, Magna Graecia University, 88100 Catanzaro, Italy. 30. Cardiology Department, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden. 31. National and Kapodistrian University of Athens, Medical School, Athens, Greece. 32. Charles University, Prague, 116 36 Czech Republic. 33. Department of Pharmacological and Biomolecular Sciences, IRCCS Multimedica, Via Milanese, 300, 20099 Sesto San Giovanni, Milan, Italy.
Abstract
AIMS: To provide contemporary data on the implementation of European guideline recommendations for lipid-lowering therapies (LLTs) across different settings and populations and how this impacts low-density lipoprotein cholesterol (LDL-C) goal achievement. METHODS AND RESULTS: An 18 country, cross-sectional, observational study of patients prescribed LLT for primary or secondary prevention in primary or secondary care across Europe. Between June 2017 and November 2018, data were collected at a single visit, including LLT in the preceding 12 months and most recent LDL-C. Primary outcome was the achievement of risk-based 2016 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) LDL-C goal while receiving stabilized LLT; 2019 goal achievement was also assessed. Overall, 5888 patients (3000 primary and 2888 secondary prevention patients) were enrolled; 54% [95% confidence interval (CI) 52-56] achieved their risk-based 2016 goal and 33% (95% CI 32-35) achieved their risk-based 2019 goal. High-intensity statin monotherapy was used in 20% and 38% of very high-risk primary and secondary prevention patients, respectively. Corresponding 2016 goal attainment was 22% and 45% (17% and 22% for 2019 goals) for very high-risk primary and secondary prevention patients, respectively. Use of moderate-high-intensity statins in combination with ezetimibe (9%), or any LLT with PCSK9 inhibitors (1%), was low; corresponding 2016 and 2019 goal attainment was 53% and 20% (ezetimibe combination), and 67% and 58% (PCSK9i combination). CONCLUSION: Gaps between clinical guidelines and clinical practice for lipid management across Europe persist, which will be exacerbated by the 2019 guidelines. Even with optimized statins, greater utilization of non-statin LLT is likely needed to reduce these gaps for patients at highest risk.
AIMS: To provide contemporary data on the implementation of European guideline recommendations for lipid-lowering therapies (LLTs) across different settings and populations and how this impacts low-density lipoprotein cholesterol (LDL-C) goal achievement. METHODS AND RESULTS: An 18 country, cross-sectional, observational study of patients prescribed LLT for primary or secondary prevention in primary or secondary care across Europe. Between June 2017 and November 2018, data were collected at a single visit, including LLT in the preceding 12 months and most recent LDL-C. Primary outcome was the achievement of risk-based 2016 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) LDL-C goal while receiving stabilized LLT; 2019 goal achievement was also assessed. Overall, 5888 patients (3000 primary and 2888 secondary prevention patients) were enrolled; 54% [95% confidence interval (CI) 52-56] achieved their risk-based 2016 goal and 33% (95% CI 32-35) achieved their risk-based 2019 goal. High-intensity statin monotherapy was used in 20% and 38% of very high-risk primary and secondary prevention patients, respectively. Corresponding 2016 goal attainment was 22% and 45% (17% and 22% for 2019 goals) for very high-risk primary and secondary prevention patients, respectively. Use of moderate-high-intensity statins in combination with ezetimibe (9%), or any LLT with PCSK9 inhibitors (1%), was low; corresponding 2016 and 2019 goal attainment was 53% and 20% (ezetimibe combination), and 67% and 58% (PCSK9i combination). CONCLUSION: Gaps between clinical guidelines and clinical practice for lipid management across Europe persist, which will be exacerbated by the 2019 guidelines. Even with optimized statins, greater utilization of non-statin LLT is likely needed to reduce these gaps for patients at highest risk.
Authors: Maciej Banach; Paweł Burchardt; Krzysztof Chlebus; Piotr Dobrowolski; Dariusz Dudek; Krzysztof Dyrbuś; Mariusz Gąsior; Piotr Jankowski; Jacek Jóźwiak; Longina Kłosiewicz-Latoszek; Irina Kowalska; Maciej Małecki; Aleksander Prejbisz; Michał Rakowski; Jacek Rysz; Bogdan Solnica; Dariusz Sitkiewicz; Grażyna Sygitowicz; Grażyna Sypniewska; Tomasz Tomasik; Adam Windak; Dorota Zozulińska-Ziółkiewicz; Barbara Cybulska Journal: Arch Med Sci Date: 2021-11-08 Impact factor: 3.318
Authors: Vivencio Barrios; Carlos Escobar; Carmen Suarez; Xavier Garcia-Moll; Francisco Lozano Journal: J Clin Med Date: 2022-06-20 Impact factor: 4.964
Authors: Alexey N Meshkov; Alexandra I Ershova; Anna V Kiseleva; Svetlana A Shalnova; Oxana M Drapkina; Sergey A Boytsov Journal: J Pers Med Date: 2021-05-24
Authors: Anne Grete Semb; Silvia Rollefstad; Eirik Ikdahl; Grunde Wibetoe; Joseph Sexton; Cindy Crowson; Piet van Riel; George Kitas; Ian Graham; Solbritt Rantapää-Dahlqvist; George Athanasios Karpouzas; Elena Myasoedova; Miguel A Gonzalez-Gay; Petros P Sfikakis; Maria G Tektonidou; Argyro Lazarini; Dimitrios Vassilopoulos; Bindee Kuriya; Carol Hitchon; Maria Simona Stoenoiu; Patrick Durez; Virginia Pascual-Ramos; Dionicio Angel Galarza-Delgado; Pompilio Faggiano; Durga Prasanna Misra; Andrew A Borg; Rong Mu; Erkin M Mirrakhimov; Diane Gheta; Karen Douglas; Vikas Agarwal; Svetlana Myasoedova; Lev Krougly; Tatiana Valentinovna Popkova; Alena Tuchyňová; Michal Tomcik; Michal Vrablik; Jiri Lastuvka; Pavel Horak; Helena Kaspar Medkova; Anne M Kerola Journal: RMD Open Date: 2021-07