Observational study of patients from a Lipid Unit on lipid-modifying therapy for primary and secondary prevention: ULFI Study

Àlex Vila , Estel Pons , Patricia Trinidad García , Daniel Vidal , Sara López , Armand Grau
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Abstract

Objectives

To evaluate the achievement of low-density lipoprotein cholesterol (LDLc) goals established by the 2019 European Guidelines for the Management of Dyslipidemias and 2021 Cardiovascular Disease Prevention Guidelines, describe the lipid-lowering treatment received, analyze the achievement of goals according to the lipid-lowering treatment received and study the factors associated with therapeutic success.

Design

Observational study that included 185 patients of both sexes aged 18 or over undergoing lipid-lowering treatment for primary or secondary prevention, attended at the Lipid Unit.

Results

62,1% of the patients had a very high cardiovascular risk (CVR) according to the 2019 guidelines, and 60,5% according to the 2021 guidelines. Of the total cases, 22,7% achieved adequate control of LDLc according to the 2019 guidelines and 20% according to the 2021 guidelines. 47,6% of the patients received very high intensity lipid-lowering treatment, and 14,1% received extremely high intensity lipid-lowering treatment. 76% of subjects with very high CVR on extremely high intensity lipid-lowering treatment achieved the therapeutic objectives of both guides. In the multivariate analysis, factors associated with therapeutic success were the presence of arteriosclerotic cardiovascular disease, the intensity of lipid-lowering treatment, diabetes mellitus, and low to moderate alcohol consumption.

Conclusions

Dyslipidemia control is improvable. High or extremely high intensity lipid-lowering treatments can contribute to optimizing control of patients with higher CVR.

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脂质单位患者对脂质调节治疗一级和二级预防的观察性研究:ULFI研究
目的评价2019年欧洲血脂异常管理指南和2021年心血管疾病预防指南制定的低密度脂蛋白胆固醇(LDLc)目标的实现情况,描述所接受的降脂治疗,根据所接受的降脂治疗分析目标的实现情况,研究治疗成功的相关因素。设计:一项观察性研究,纳入185名18岁或以上的男女患者,在脂质科接受一级或二级预防降脂治疗。结果根据2019年指南,621.1%的患者心血管风险极高,根据2021年指南,60.5%的患者心血管风险极高。在所有病例中,22.7%的病例根据2019年指南实现了对最不发达国家的充分控制,20%的病例根据2021年指南实现了充分控制。47.6%的患者接受了非常高强度的降脂治疗,14.1%的患者接受了极高强度的降脂治疗。在接受极高强度降脂治疗的非常高CVR患者中,76%达到了两个指南的治疗目标。在多变量分析中,与治疗成功相关的因素是动脉硬化性心血管疾病的存在、降脂治疗的强度、糖尿病和低至中度饮酒。结论血脂控制有明显改善。高强度或极高强度的降脂治疗有助于优化高CVR患者的控制。
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