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Climent E, Millán J, Ascaso JF, Suárez-Tembra M, Morillas C, Civeira F, Bellón JM, Pedro-Botet J. Atherogenic dyslipidaemia in type 2 diabetes mellitus: The PREDISAT study. Lipids 2023; 58:197-206. [PMID: 37291984 DOI: 10.1002/lipd.12374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/17/2023] [Accepted: 05/24/2023] [Indexed: 06/10/2023]
Abstract
Extremely variable prevalence rates of atherogenic dyslipidaemia (AD) in type 2 diabetes (T2DM) subjects have been reported. The primary aim was to assess AD prevalence in Spanish T2DM subjects. Secondary objectives were to evaluate the differential clinical characteristics between T2DM subjects with and without AD, to describe lipid profile evolution and use of lipid-lowering treatment in clinical practice by the Spanish Lipid Units. Data was obtained from the National Registry of Dyslipidaemias of the Spanish Atherosclerosis Society, from a multicentric sub-study focused on AD prevalence in T2DM subjects (PREDISAT study). The inclusion criteria were subjects diagnosed of T2DM with age ≥18 years old. A total of 385 T2DM subjects with a mean age of 61 years and 246 (64%) men were included. The mean follow-up was 22 ± 7.4 months. At baseline, 41.3% of the T2DM subjects presented AD, this percentage decreasing to 34.8% with therapeutic intervention. AD prevalence varied in different age groups and appeared to be more prevalent in younger T2DM subjects. Those with AD had a more atherogenic lipid profile at baseline, with higher total cholesterol, triglyceride and non-(high-density lipoprotein) HDL cholesterol levels at baseline, together with lower HDL cholesterol concentrations, without achieving lipid subfraction goals during follow-up. Although almost 90% of the AD subjects were under lipid-lowering treatment, most were receiving only one drug, being statins the most used treatmentA high AD prevalence in T2DM subjects was observed, being age a determinant factor, with a modest decline during follow-up. Although almost 90% of the AD subjects were under lipid-lowering drugs, most were only receiving monotherapy with statins.
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Affiliation(s)
- Elisenda Climent
- Department of Endocrinology and Nutrition, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jesús Millán
- School of Medicine, Universidad Complutense, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Juan F Ascaso
- School of Medicine, University of Valencia, Valencia, Spain
| | | | - Carlos Morillas
- Lipid Unit, Hospital Universitario Dr. Peset, Valencia, Spain
| | - Fernando Civeira
- Lipid Unit, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Jose M Bellón
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Juan Pedro-Botet
- Department of Endocrinology and Nutrition, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
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Pallarés-Carratalá V, Barrios V, Fierro-González D, Polo-García J, Cinza-Sanjurjo S. Cardiovascular Risk in Patients with Dyslipidemia and Their Degree of Control as Perceived by Primary Care Physicians in a Survey-TERESA-Opinion Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2388. [PMID: 36767754 PMCID: PMC9915170 DOI: 10.3390/ijerph20032388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/22/2023] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate, through a survey, the opinion of primary care (PC) physicians on the magnitude of dyslipidemia and its degree of control in their clinical practice. MATERIALS AND METHODS An ecological study was carried out, in which the physicians were invited to participate by means of an online letter. Data were collected at a single timepoint and were based only on the experience, knowledge, and routine clinical practice of the participating physician. RESULTS A total of 300 physicians answered the questionnaire and estimated the prevalence of dyslipidemia between 2% and 80%. They estimated that 23.5% of their patients were high-risk, 18.2% were very high-risk, and 14.4% had recurrent events in the last 2 years. The PC physicians considered that 61.5% of their patients achieved the targets set. The participants fixed the presence of side-effects to statins at 14%. The statin that was considered safest with regard to side-effects was rosuvastatin (69%). CONCLUSIONS PC physicians in Spain perceive that the CVR of their patients is high. This, together with the overestimation of the degree of control of LDL-C, could justify the inertia in the treatment of lipids. Moreover, they perceive that one-sixth of the patients treated with statins have side-effects.
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Affiliation(s)
- Vicente Pallarés-Carratalá
- Health Surveillance Unit, Unión de Mutuas, 12004 Castellón de la Plana, Spain
- Department of Medicine, Universitat Jaume I, 12071 Castellón de la Plana, Spain
| | - Vivencio Barrios
- Cardiology Department, H Ramón y Cajal, 28034 Madrid, Spain
- Department of Medicine, Alcala University, 28801 Madrid, Spain
| | | | | | - Sergio Cinza-Sanjurjo
- Milladoiro Health Centre, 15895 Santiago de Compostela, Spain
- Instituto de Investigación de Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
- Centro de Investigación Biomédica en Red-Enfermedades Cardiovasculares (CIBER-CV), 28029 Madrid, Spain
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Safaryan AS, Vygodin VA. Analysis of lipid-lowering therapy depending on socio-demographic factors in primary health care: data from the ARGO study. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2023. [DOI: 10.15829/1728-8800-2022-3445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Aim. To study the relationship of socio-demographic factors with lipidlowering therapy in primary health care.Material and methods. This cross-sectional noncomparative study on the prevalence of hypercholesterolemia (ARGO study) included patients aged ≥0 years who visited primary care physicians and cardiologists in the period 2013-2014 with diagnoses of stable coronary artery disease, hypertension, peripheral artery disease, carotid atherosclerosis, aortic aneurysm or having any type of revascularization or ischemic stroke in history. The study, which was conducted in 59 Russian cities, involved 768 doctors from 217 polyclinics.Results. The analysis included 18273 patients. Of the total number of patients, 7829 (42,9%) people took statins, while 10421 (57,1%) people did not receive it. The maximum percentage of statin use was in the age group of 70-79 years — 52,12%, and the minimum in the age group of 30-39 years — 13,24% (p<0,001). Most often, statins were taken by people with disabilities — 67,67%, and least often, by working people — 32,59% (p<0,001). In terms of marital status, widowed persons were significantly more likely to take statins, 50,36% (p<0,001); least of all in the group, single persons — 32,29%, while in the group of divorced persons, statins were taken by 37,76%, and in the group of married — 43,07%. According to the education level, patients with secondary professional education are the most adherent to statin treatment — 43,75%, while patients with incomplete secondary education were the least likely to take statins — 41,26% (p<0,054).Conclusion. Taking into account the socio-demographic factors that a person has when prescribing treatment will help develop a strategy for interacting with the patient and will help improve the quality and effectiveness of therapy in this group of patients.
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Affiliation(s)
- A. S. Safaryan
- National Medical Research Center for Therapy and Preventive Medicine
| | - V. A. Vygodin
- National Medical Research Center for Therapy and Preventive Medicine
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Zirak MR, Mehri S, Karimani A, Zeinali M, Hayes AW, Karimi G. Mechanisms behind the atherothrombotic effects of acrolein, a review. Food Chem Toxicol 2019; 129:38-53. [DOI: 10.1016/j.fct.2019.04.034] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 03/18/2019] [Accepted: 04/18/2019] [Indexed: 12/31/2022]
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Kutkiene S, Petrulioniene Z, Laucevicius A, Matuzeviciene G, Kasiulevicius V, Petrulionyte E, Staigyte J, Saulyte A, Gargalskaite U, Skiauteryte E, Kovaite M, Rinkuniene E. Cardiovascular risk profile of patients with atherogenic dyslipidemia in middle age Lithuanian population. Lipids Health Dis 2018; 17:208. [PMID: 30185180 PMCID: PMC6123979 DOI: 10.1186/s12944-018-0851-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 08/17/2018] [Indexed: 11/15/2022] Open
Abstract
Background Atherogenic dyslipidemia (AD) is a blood serum lipid profile abnormality characterized by elevation of triglycerides and reduced levels of high density lipoprotein cholesterol (HDL-C). It is associated with residual cardiovascular risk. This study evaluated and compared the risk profiles of patients with hypertriglyceridemia, low-HDL-C levels or AD, in order to understand, which lipid profile is associated with greater risk. Methods During the period of 2009–2016 a population of 92,373 Lithuanian adults (men 40–54 years old and women 50–64 years old) without overt cardiovascular disease were analyzed. Data of 25,746 patients (68.6% women and 31.4% men) with hypertriglyceridemia and/or low HDL-C low levels were collected and used for further statistical analysis. Results Participants with AD tend to have more unfavorable risk profile than participants with hypertriglyceridemia or low-HDL-C. AD tends to cluster with other atherogenic risk factors, such as arterial hypertension [odds ratio (OR) 1.96, 95% confidence intervals (CI) 1.87–2.01], smoking [OR 1.20, 95% CI 1.14–1.27], diabetes mellitus [OR 2.74, 95% CI 2.58–2.90], obesity [OR 2.92, 95% CI 2.78–3.10], metabolic syndrome [OR 22.27, 95% CI 20.69–23.97], unbalanced diet [OR 1,59, 95% CI 1.51–1.68], low physical activity [OR 1.80, 95% CI 1.71–1,89], CHD history in first degree relatives [OR 1.18, 95% CI 1.12–1.25] and total number of risk factors [OR 1.47, 95% CI 1.38–1.57]. Conclusion AD is associated with more unfavorable cardiovascular risk profile than hypertriglyceridemia or low-HDL cholesterol levels. Once identified AD should require additional medical attention since it is an important factor of residual cardiovascular risk.
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Affiliation(s)
- Sandra Kutkiene
- Faculty of Medicine, Clinic of Cardiac and Vascular Diseases, Vilnius University, Vilnius, Lithuania. .,Faculty of Medicine, Vilnius University, Vilnius, Lithuania. .,Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.
| | - Zaneta Petrulioniene
- Faculty of Medicine, Clinic of Cardiac and Vascular Diseases, Vilnius University, Vilnius, Lithuania.,Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Aleksandras Laucevicius
- Faculty of Medicine, Clinic of Cardiac and Vascular Diseases, Vilnius University, Vilnius, Lithuania.,Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Gabija Matuzeviciene
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Vytautas Kasiulevicius
- Faculty of Medicine, Clinic of Internal Diseases, Family Medicine and Oncology, Vilnius University, Vilnius, Lithuania.,Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | | | | | - Akvile Saulyte
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Urte Gargalskaite
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Egle Skiauteryte
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Milda Kovaite
- Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Egidija Rinkuniene
- Faculty of Medicine, Clinic of Cardiac and Vascular Diseases, Vilnius University, Vilnius, Lithuania.,Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
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Ding R, Ye P, Zhao S, Zhao D, Yan X, Dong Y, Li J, Ran Y, Hu D. Effect of physician characteristics and knowledge on the quality of dyslipidemia management and LDL-C target goal achievement in China: Subgroup analysis of the Dyslipidemia International Study. J Glob Health 2018; 7:020702. [PMID: 29057073 PMCID: PMC5644362 DOI: 10.7189/jogh.07.020702] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Objective This study aimed to investigate the effect of physicians’ characteristics and knowledge of LDL–C target goals on the quality of lipid management in China. Methods A total of 25 317 dyslipidemia patients who had taken lipid–lowering medication for >3 months were enrolled in our study. Patients’ demographic data, medical history, lipid profile, their physician’s specialty and professional title and their hospital level as well as their LDL–C goal opinions were recorded. Results Questionnaires were completed by 926 physicians with 6 different specialties and 4 professional statuses, in 3 different–level hospitals. Most (74.5%) of the physicians recognized the importance of considering LDL–C serum concentration for treating dyslipidemia, and set target LDL–C goals according to the 2007 Chinese guidelines for 83.4% of their patients. The LDL–C goal achievement rate was significantly higher for patients whose physicians’ knowledge of LDL–C target goals was consistent with guideline recommendations, compared with those whose physicians’ knowledge was inconsistent with the guidelines (60.4% vs 31.1%, P < 0.0001). Physicians working in tier 1 (odds ration (OR) = 2.95; 95% CI 2.37–3.67), (OR = 1.56; 95% CI 1.34–1.81) and tier 2 (OR = 2.53; 95% CI 2.22–2.88), (OR = 1.16; 95% CI 1.06–1.27) hospitals, specialized in neurology (OR = 1.13; 95% CI 0.93–1.36), (OR = 1.57; 95% CI 1.40–1.77), internal medicine (OR = 1.07; 95% CI 0.90–1.27), (OR = 1.58; 95% CI 1.39–1.80), endocrinology (OR = 1.02; 95% CI 0.87–1.21), (OR = 1.63; 95% CI 1.47–1.82) and being a resident vs attending physician (OR = 1.05; 95% CI 0.92–1.20), (OR = 1.00; 95% CI 1.00–1.19) were independent risk factors for low knowledge of LDL–C target goals and low LDL–C goal achievement. Conclusion Chinese physicians’ characteristics and knowledge of LDL–C target goals were associated with patients’ LDL–C goal achievement.
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Affiliation(s)
- Rongjing Ding
- Department of Cardiology, Peking University People's Hospital, Beijing, China
| | - Ping Ye
- Department of Gerontology, Chinese PLA General Hospital, Medical School of Chinese PLA, Beijing, China
| | - Shuiping Zhao
- Department of Cardiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Dong Zhao
- Institute of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xiaowei Yan
- Department of Cardiology, Peking Union Medical College Hospital, Beijing, China
| | - Yugang Dong
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jihu Li
- Outcome Research, Merck Sharp & Dohme (China) Holding Ltd., Shanghai, China
| | - Yuqin Ran
- Medical Affairs, Merck Sharp & Dohme (China) Holding Ltd., Shanghai, China
| | - Dayi Hu
- Department of Cardiology, Peking University People's Hospital, Beijing, China
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Masson W, Siniawski D, Lobo M, Molinero G. Lipid discordance and carotid plaque in obese patients in primary prevention. ACTA ACUST UNITED AC 2017; 65:39-44. [PMID: 29162370 DOI: 10.1016/j.endinu.2017.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 08/29/2017] [Accepted: 09/07/2017] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Obese patients with lipid discordance (non-HDL cholesterol levels 30mg/dL above the LDL-c value) may have a greater prevalence of carotid atherosclerotic plaque (CAP). Our study objectives were: 1) To assess the prevalence of lipid discordance in a primary prevention population of obese patients; 2) To investigate the association between lipid discordance and presence of CAP. METHODS Obese subjects aged >18 years (BMI ≥30kg/m2) with no cardiovascular disease, diabetes, or lipid-lowering treatment from six cardiology centers were included. Lipid discordance was defined when, regardless of the LDL-c level, the non-HDL cholesterol value exceeded the LDL-c value by 30mg/dL. Presence of CAP was identified by ultrasonography. Univariate and multivariate analyses were performed to explore the association between lipid discordance and presence of CAP. RESULTS The study simple consisted of 325 obese patients (57.2% men; mean age, 52.3 years). Prevalence of lipid discordance was 57.9%. CAP was found in 38.6% of patients, but the proportion was higher in subjects with lipid discordance as compared to those without this lipid pattern (44.4% vs. 30.7%, P=.01). In both the univariate (OR: 1.80; 95% CI: 1.14-2.87; P=.01) and the multivariate analysis (OR: 2.07; 95% CI: 1.22-3.54; P=.007), presence of lipid discordance was associated to an increased probability of CAP. CONCLUSION In these obese patients, lipid discordance was associated to greater prevalence of CAP. Evaluation of obese patients with this strategy could help identify subjects with higher residual cardiovascular risk.
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Affiliation(s)
- Walter Masson
- Consejo de Epidemiología y Prevención Cardiovascular, Sociedad Argentina de Cardiología, Ciudad Autónoma de Buenos Aires, Argentina.
| | - Daniel Siniawski
- Consejo de Epidemiología y Prevención Cardiovascular, Sociedad Argentina de Cardiología, Ciudad Autónoma de Buenos Aires, Argentina
| | - Martín Lobo
- Consejo de Epidemiología y Prevención Cardiovascular, Sociedad Argentina de Cardiología, Ciudad Autónoma de Buenos Aires, Argentina
| | - Graciela Molinero
- Consejo de Epidemiología y Prevención Cardiovascular, Sociedad Argentina de Cardiología, Ciudad Autónoma de Buenos Aires, Argentina
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Masson W, Lobo M, Molinero G, Siniawski D. Discordant Lipid Pattern and Carotid Atherosclerotic Plaque. Importance of Remnant Cholesterol. Arq Bras Cardiol 2017; 108:526-532. [PMID: 28699976 PMCID: PMC5489322 DOI: 10.5935/abc.20170069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 02/08/2017] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND: Subjects with levels of non-HDL-C 30 mg/dL above those of LDL-C (lipid discordance) or with high remnant cholesterol levels could have a greater residual cardiovascular risk. OBJECTIVES: To determine the prevalence of lipid discordance in a primary prevention population and analyze the clinical variables associated with it; To investigate the association between lipid discordance and remnant cholesterol with the presence of carotid plaque. METHODS: Primary prevention patients without diabetes or lipid-lowering therapy were included. Regardless of the LDL-C level, we define "lipid discordance" if the non-HDL-C value exceeded 30 mg/dL that of LDL-C. Remnant cholesterol was calculated as total cholesterol minus HDL-C minus LDL-C when triglycerides were < 4.0 mmol/L. Ultrasound was used to assess carotid plaque occurrence. Multiple regression logistic models were performed. RESULTS: The study included 772 patients (mean age 52 ± 11 years, 66% women). The prevalence of lipid discordance was 34%. Male sex and body mass index were independently associated with discordant lipid pattern. The prevalence of carotid plaque was higher in subjects with lipid discordance (40.2% vs. 29.2, p = 0.002). The multivariate analysis showed that the discordant lipid pattern was associated with the greater probability of carotid plaque (OR 1.58, 95% CI 1.08-2.34, p = 0.02). Similarly, a significant association between calculated remnant cholesterol and carotid plaque was found. CONCLUSION: Lipid discordance and presence of a higher level of calculated remnant cholesterol are associated with subclinical atherosclerosis. Our findings could be used to improve the residual cardiovascular risk evaluation. FUNDAMENTO: Indivíduos com níveis de não HDL-C excedendo em 30 mg/dl aqueles de LDL-C (discordância lipídica) ou com altos níveis de colesterol remanescente poderiam ter maior risco cardiovascular residual. OBJETIVOS: determinar a prevalência de discordância lipídica em uma população de prevenção primária e analisar as variáveis clínicas com ela associadas; investigar a associação de discordância lipídica e colesterol remanescente calculado com a presença de placa carotídea. MÉTODOS: Pacientes de prevenção primária sem diabetes ou sem terapia hipolipemiante foram incluídos. Independentemente do nível de LDL-C, definiu-se "discordância lipídica" como um valor de não HDL-C excedendo em 30 mg/dl aquele de LDL-C. Calculou-se o colesterol remanescente como colesterol total menos HDL-C menos LDL-C na presença de triglicerídeos < 4,0 mmol/l. Usou-se ultrassom para avaliar a presença de placa carotídea. Modelos de regressão logística múltipla foram construídos. RESULTADOS: Este estudo incluiu 772 pacientes (idade média, 52 ± 11 anos; 66% mulheres). A prevalência de discordância lipídica foi de 34%. Sexo masculino e índice de massa corporal mostraram associação independente com padrão lipídico discordante. A prevalência de placa carotídea foi maior em indivíduos com discordância lipídica (40,2% vs. 29,2; p = 0,002). A análise multivariada mostrou associação do padrão lipídico discordante com maior probabilidade de placa carotídea (OR: 1,58; IC95%: 1,08-2,34; p = 0,02). Da mesma forma, identificou-se uma significativa associação entre colesterol remanescente calculado e placa carotídea. CONCLUSÃO: Discordância lipídica e presença de nível mais alto de colesterol remanescente calculado acham-se associados com aterosclerose subclínica. Nossos achados podem ser usados para aprimorar a avaliação de risco cardiovascular residual.
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Affiliation(s)
- Walter Masson
- Hospital Italiano de Buenos Aires, Servicio de Cardiología - Argentina.,Consejo de Epidemiología. Sociedad Argentina de Cardiología - Argentina
| | - Martín Lobo
- Consejo de Epidemiología. Sociedad Argentina de Cardiología - Argentina
| | - Graciela Molinero
- Consejo de Epidemiología. Sociedad Argentina de Cardiología - Argentina
| | - Daniel Siniawski
- Hospital Italiano de Buenos Aires, Servicio de Cardiología - Argentina.,Consejo de Epidemiología. Sociedad Argentina de Cardiología - Argentina
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Masana L, Plana N. [Update of planning tables of cholesterol-lowering therapy orientated to achieve LDL therapeutic targets]. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2015; 27:138-43. [PMID: 25865752 DOI: 10.1016/j.arteri.2015.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 02/10/2015] [Accepted: 02/13/2015] [Indexed: 10/23/2022]
Abstract
This is the third update of a planning-table for use in cholesterol-lowering therapy, so as to obtain LDLc objectives. This is an easy to use laptop tool to help choose the best statin or combination therapy (statin plus ezetimibe) depending on the current LDL concentration of the patient, and the LDLc objective to achieve. It is based on a colour code that indicates the drugs that are efficient enough to help patients to achieve their LDL goal. Along with the table, recommendations are given for the best strategy in order to implement the optimal therapy in a maximum of two clinical encounters.
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Affiliation(s)
- Luis Masana
- Unitat de Medicina Vascular i Metabolisme, Hospital Universitari Sant Joan, IISPV, CIBERDEM, Universitat Rovira i Virgili, Reus, España, Reus, Tarragona, España.
| | - Núria Plana
- Unitat de Medicina Vascular i Metabolisme, Hospital Universitari Sant Joan, IISPV, CIBERDEM, Universitat Rovira i Virgili, Reus, España, Reus, Tarragona, España
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Pascual Fuster V, Ruiz Olivar E, Pintò Sala X. [Patient's care and management of dyslipidemia in type 2 diabetic patients in the clinical practice in Spain: The LIPEDIA study]. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2015; 27:45-56. [PMID: 25112553 DOI: 10.1016/j.arteri.2014.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 06/04/2014] [Accepted: 06/11/2014] [Indexed: 06/03/2023]
Abstract
INTRODUCTION Treatment of atherogenic dyslipidemia (AD) in type 2 diabetes (DM2) should focus on the global control of dyslipidemia. The aim of this study was to determine how hospital (MSs) and primary care specialist (GPs) from Spain manage AD in DM2 during their daily practice. METHODS An observational, cross-sectional, multicentric study was conducted. Information about daily practice was obtained from 497 MSs and 872 GPs across Spain. RESULTS 66% of MSs and 30.5% of GPs considered DM2 patients to be high-risk. Most consider the c-LDL targets based on European guidelines. The statins most widely used are atorvastatin and simvastatin. However both MSs and GPs considered rosuvastatin to be the most appropriate statin for these patients. 82% of MSs and 68% of GPs considered that >50% of their patients achieved the c-LDL target. The main reasons of not achieving this target were lack of treatment adherence and pressure from the administration. Seventy four percent of MSs reported that there are no common clinical protocols with GPs. CONCLUSIONS The differences in the perception of the real cardiovascular risk of the patient, low use of more appropriate statins, lack of adherence and poor perception of real c-LDL control may contribute to the failure in achieving lipid targets in DM2.
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Affiliation(s)
| | | | - Xavier Pintò Sala
- Unidad de Lípidos y Riesgo Vascular, Servicio de Medicina Interna, Hospital Universitario de Bellvitge, CiberObn, Fipec, Idibell, Hospitalet de Llobregat, Barcelona, España
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11
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Characterization of lipid parameters in diabetic and non-diabetic atherosclerotic patients. JOURNAL OF GERIATRIC CARDIOLOGY : JGC 2015; 12:37-43. [PMID: 25678903 PMCID: PMC4308457 DOI: 10.11909/j.issn.1671-5411.2015.01.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Revised: 10/20/2014] [Accepted: 10/27/2014] [Indexed: 11/21/2022]
Abstract
Background & Objective The relationship between lipid profile perturbation and diabetes associated complications has long been an area of interest. Dyslipidemia is a potent predictor of cardiovascular morbidity and mortality in diabetic patients. The aim of present study was to investigate relationship between aging and lipid profiles in diabetic and non-diabetic atherosclerotic patients. Methods Five hundred and seventy six individuals (45–75 year age) participated in this study. Among these, 192 were having history of diabetes mellitus and atherosclerosis. Individuals are categorized on the base of health (normal, non-diabetic atherosclerosis, diabetic atherosclerosis) and age (45–55 years, 56–65 years, and 66–75 years). All the participants were subjected to the procedures like a detailed history, biochemical analysis for fasting blood sugar, hemoglobin A1c, total cholesterol (TC), triglycerides (TG), low-density lipoprotein-(LDL), very low-density lipoprotein (VLDL) and high-density lipoprotein (HDL). All these parameters were compared between diabetic and non-diabetic atherosclerotic patients of all three age groups. TC/HDL and LDL/HDL were also calculated. Results Diabetic atherosclerotic individuals (both males and females) had high level of TC, TG, LDL, VLDL and low level of HDL in comparison to non-diabetic atherosclerotic and normal control individuals. Among all three age groups, lipoprotein abnormality was observed to be more frequent in females than males. There was a significant increase in TC/HDL and LDL/HDL ratio in diabetic atherosclerotic subjects compared to age and sex matched non-diabetic atherosclerotic and normal control. Conclusions Degree of dyslipidemia increases with increase in age in both genders. Female are more prone to diabetic dyslipidemia and hence have more risk of developing atherosclerosis with increasing age.
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