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Kızılırmak P, Öngen Z, Güleç S, Kayıkçıoğlu M, Kılıçkap M, Abacı A, Özer N, Aydoğdu S, Temizhan A, Yılmaz MB, Bozkurt E, Dölek B, Tokgözoğlu L, Tokgozoglu L. Lipid Modification to Reduce Cardiovascular Risk in Secondary Prevention Patients with Special Emphasis on PCSK9 Inhibitor Requirement: An Analysis Based on Delphi Panel Approach. Turk Kardiyol Dern Ars 2022; 50:554-560. [PMID: 35976247 DOI: 10.5543/tkda.2022.22367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE The aim of this study is to analyze the low-density lipoprotein cholesterol-lowering therapies in secondary prevention patients by analyzing their plasma low-density lipoprotein cholesterol levels, current treatment, considering their inadequate response to medications (as defined in current guidelines), and the requirement for a protein convertase subtilisin/kexin type 9 inhibitor. METHODS Delphi panel is used to seek expert consensus of experienced 12 cardiologists. A questionnaire consisting of 6 main questions is used to reflect the opinion of the expert panelists on the practices of low-density lipoprotein cholesterol-lowering therapies of patients with high and very high cardiovascular risk. Patients with atherosclerotic cardiovascular disease are covered in this present analysis. RESULTS According to expert opinion data, 18.6% of the patient population with atherosclerotic cardiovascular disease is estimated to have experienced recurrent vascular events. The current treatment of the patient population is 39.7% on high dose, 36.9% on low/moderate dose of statin, 13.1% on maximum tolerated dose statin+ezetimibe, and 1.2% on maximum tolerated dose statin+ezetimibe+protein convertase subtilisin/kexin type 9 inhibitor. The percentage of atherosclerotic cardiovascular disease patients with inadequate treatment response is estimated to be 20.2% in those using "maximum tolerated dose statin+ezetimibe." The proportion of patients who will need to be treated with a protein convertase subtilisin/kexin type 9 inhibitor increases as their low-density lipoprotein cholesterol levels rises from 9.1% in 70-99 mg/dL to 50.8% in ≥160 mg/dL for these patients. CONCLUSION According to expert opinion, although a substantial proportion of patients with secondary prevention have not achieved low-density lipoprotein cholesterol goals, the use of protein convertase subtilisin/kexin type 9 inhibitors is very low. Since the questionnaire subject to panel discussion did not include any question elaborating the issue, the discrepancy between the recommendation of the related guidelines and Turkish practice needs further studies for the explanation.
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Affiliation(s)
| | - Zeki Öngen
- Department of Cardiology, Cerrahpaşa University Faculty of Medicine, İstanbul Turkey
| | - Sadi Güleç
- Department of Cardiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Meral Kayıkçıoğlu
- Department of Cardiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Mustafa Kılıçkap
- Department of Cardiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Adnan Abacı
- Department of Cardiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Necla Özer
- Department of Cardiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Sinan Aydoğdu
- Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ahmet Temizhan
- Department of Cardiology, Health Sciences University Ankara City Hospital, Ankara, Turkey
| | - Mehmet Birhan Yılmaz
- Department of Cardiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Engin Bozkurt
- Department of Cardiology, Medicana International Ankara Hospital, Ankara, Turkey
| | | | - Lale Tokgözoğlu
- Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Doğduş M, Turan OE, Başkurt AA, Yılancıoğlu RY, Özgül U, İnevi UD, Özcan EE, Ozcan EE. Answer Regarding P Wave Index and Atrial Fibrillation Recurrence. Turk Kardiyol Dern Ars 2022; 50:623. [PMID: 36476962 DOI: 10.5543/tkda.2022.2263622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Mustafa Doğduş
- Department of Cardiology, Uşak University Training and Research Hospital, Uşak, Turkey
| | - Oğuzhan Ekrem Turan
- Heart Rhythm Management Center, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Ahmet Anıl Başkurt
- Department of Cardiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | | | - Ufuk Özgül
- Department of Cardiology, Aydın Atatürk State Hospital, Aydın, Turkey
| | | | - Emin Evren Özcan
- Heart Rhythm Management Center, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
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Guzel T, Kis M. Relationship Between Coronary Lesion Severity Detected in Fractional Flow Reserve with Monocyte/High-Density Lipoprotein, Neutrophil/ Lymphocyte, Lymphocyte/Monocyte, and Platelet/ Lymphocyte Ratios: Which Is Most Important? Eur J Ther 2022. [DOI: 10.5152/eurjther.2022.22037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Dogdus M, Turan OE, Baskurt AA, Yilancioglu RY, Ozgul U, Inevi UD, Ozcan EE. An Effective Novel Index for Predicting the Recurrence of Atrial Fibrillation Ablation: P Wave Duration-to-Amplitude Ratio. Turk Kardiyol Dern Ars 2022; 50:498-504. [DOI: 10.5543/tkda.2022.22416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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