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Gomez-Barrado JJ, Gomez-Turegano P, Ortiz-Cortes C, Vega-Fernandez J, Gomez-Turegano M, Garciperez de Vargas FJ, Lezcano Gort LE, Kounka Z, Roque Rodriguez B, Chipayo Gonzales D, Perez-Espejo P, Fernandez-Chamorro AI, Beltran Moreno M, Romero Castro MJ, Mogollon Jimenez MV, Marcos Gomez G, Porras Ramos Y. Low-Density Lipoprotein Cholesterol Targets in Patients With Coronary Heart Disease in Extremadura (Spain): LYNX Registry. Cardiol Res 2020; 11:311-318. [PMID: 32849966 PMCID: PMC7430891 DOI: 10.14740/cr1079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 05/11/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Low-density lipoprotein cholesterol (LDL-C) contributes decisively to the development of cardiovascular disease (CVD). In the LYNX registry we determined the rate of achievement of the target value of LDL-C, the use of lipid-lowering therapy (LLT) and the predictive factors of not reaching the target in patients with stable coronary heart disease (CHD). METHODS LYNX included consecutive patients with stable CHD treated at the University Hospital of Caceres, Extremadura (Spain) from September 2016 to September 2018, and those who must have an LDL-C target below 70 mg/dL according to the European Society of Cardiology (ESC) 2016 guidelines. The variables independently associated with the breach of the LDL-C objective were evaluated by multivariable logistic regression. RESULTS A total of 674 patients with stable CHD were included. The average LDL-C levels were 68.3 ± 24.5 mg/dL, with 56.7% showing a level below 70 mg/dL. LLT was used by 96.7% of patients, 71.7% were treated with high-powered statins and 30.1% with ezetimibe. The risk of not reaching the target value of LDL-C was higher in women, in active smokers, and in those who had multivessel CHD or had atrial fibrillation. Patients with diabetes mellitus, those who took potent statins or co-administration treatment with ezetimibe were more likely to reach the target level of LDL-C. CONCLUSIONS The treatment of dyslipidemia in patients with chronic CHD remains suboptimal; however, an increasing number of very high-risk patients achieve the LDL-C objective, although there is still enormous potential to improve cardiovascular outcome through the use of more intensive LLT.
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Affiliation(s)
- Jose Javier Gomez-Barrado
- San Pedro de Alcantara University Hospital, Caceres, Extremadura, Spain
- Department of Biomedical Sciences, University of Extremadura, Extremadura, Spain
| | | | | | | | | | | | | | - Zineb Kounka
- San Pedro de Alcantara University Hospital, Caceres, Extremadura, Spain
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Morales C, Plana N, Arnau A, Matas L, Mauri M, Vila À, Vila L, Soler C, Montesinos J, Masana L, Pedro-Botet J. Causes of failure to achieve the low density lipoprotein cholesterol therapeutic target in patients with high and very high vascular risk controlled in Lipid and Vascular Risk Units. EROMOT study. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS 2017; 30:1-9. [PMID: 28916128 DOI: 10.1016/j.arteri.2017.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 07/07/2017] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Determination of the level of achievement of the low density lipoprotein cholesterol (LDL-C) therapeutic target in patients with high and very high vascular risk treated in Lipid Units, as well as the causes of non-achievement. PATIENTS AND METHOD Multicentre retrospective observational study that included patients over 18 years with high and very high vascular risk, according to the criteria of the 2012 European Guidelines on Cardiovascular Disease Prevention, referred consecutively to Lipid Units between January and June 2012 and with follow-up two years after the first visit. RESULTS The study included a total of 243 patients from 16 lipid units. The mean age was 52.2 years (SD 13.7), of whom 62.6% were males, and 40.3% of them were very high risk. At the first visit, 86.8% (25.1% in combination) and 95.0% (47.3% in combination) in the second visit (P<.001) were treated with lipid-lowering treatment. The therapeutic target was achieved by 28% (95 CI: 22.4-34.1). As regards the causes of non-achievement, 24.6% were related to the medication (10.3% maximum tolerated dose and 10.9% due to the appearance of adverse effects), 43.4% due to the physician (19.4% by inertia, 13.7% considering that target already reached), and 46.9% due to the patient, highlighting the therapeutic non-compliance (31,4%). CONCLUSIONS LDL-C targets were achieved in about one-third of patients. The low adherence of the patient, followed by medical inertia are the most frequent causes that can explain these results.
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Affiliation(s)
- Clotilde Morales
- Servei de Medicina Interna, Unitat de Lípids i Risc Vascular, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Barcelona, España.
| | - Núria Plana
- Unitat de Medicina Vascular i Metabolisme (UVASMET), Hospital Universitari Sant Joan de Reus, Universitat Rovira i Virgili de Reus, Reus, Tarragona, España
| | - Anna Arnau
- Unitat de Recerca i Innovació, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Barcelona, España
| | - Laia Matas
- Servei de Medicina Interna, Unitat de Risc Vascular i Lípids, Hospital de Sant Pau de Barcelona, Barcelona, España
| | - Marta Mauri
- Servei de Medicina Interna, Unitat de Lípids, Consorci Sanitari de Terrassa-Hospital de Terrassa, Terrassa, Barcelona, España
| | - Àlex Vila
- Servei de Medicina Interna, Unitat de Lípids, Hospital de Figueres, Figueres, Girona, España
| | - Lluís Vila
- Servei d'Endocrinologia i Nutrició, Unitat de Lípids, Hospital Sant Joan Despí Moisès Broggi, Consorci Sanitari Integral, Sant Joan Despí, Barcelona, España
| | - Cristina Soler
- Hospital de Santa Caterina de Salt, Parc Hospitalari Martí i Julià, Salt, Girona, España
| | - Jesús Montesinos
- Unitat de Recerca i Innovació, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Barcelona, España
| | - Lluís Masana
- Unitat de Medicina Vascular i Metabolisme (UVASMET), Hospital Universitari Sant Joan de Reus, Universitat Rovira i Virgili de Reus, Reus, Tarragona, España
| | - Juan Pedro-Botet
- Unitat de Lípids i Risc Vascular, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, España
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Pedro-Botet J, Climent E. [A glow in the secondary prevention of cardiovascular disease]. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2017; 29:20-21. [PMID: 28173922 DOI: 10.1016/j.arteri.2017.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 01/19/2017] [Indexed: 06/06/2023]
Affiliation(s)
- Juan Pedro-Botet
- Unidad de Lípidos y Riesgo Vascular, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, España.
| | - Elisenda Climent
- Unidad de Lípidos y Riesgo Vascular, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, España
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