Prevalence of high-risk cardiovascular patients with therapy-resistant hypercholesterolemia.

Cardiovascular endocrinology Pub Date : 2017-06-01 Epub Date: 2016-10-14 DOI:10.1097/XCE.0000000000000098
Karel Kostev, Klaus G Parhofer, Franz-Werner Dippel
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引用次数: 6

Abstract

Introduction Hypercholesterolemia is a causal risk factor for cardiovascular diseases, which is recommended to be treated at least in high-risk patients. Yet, currently there is a lack of epidemiological data on the number of high-risk patients in Germany who do not respond adequately to high-dose statin monotherapy or statin therapy in combination with other lipid-lowering agents. Methods Of a total of over 2.6 million patient records from general practitioners in the IMS Disease Analyzer database, all high-risk cardiovascular patients with hypercholesterolemia who did not reach target low-density lipoprotein-cholesterol (LDL-C) levels despite at least 12 months of maximum lipid-lowering therapy and optimal medication supply (medication possession rate≥80%) were selected over a defined period. Results On the basis of the practice data, a total of 602 133 patients with a high cardiovascular risk who were treated with statin monotherapy or statin combination therapy with optimal medication supply (medication possession rate≥80%) for at least 12 months were identified. Of them, 49 406 patients received high-dose statin therapy, and 51 869 patients received statin therapy in any dose in combination with another lipid-lowering agent. A total of 79 848 high-risk patients did not reach the target LDL-C level of 70 mg/dl or less despite consistent lipid-lowering therapy; of them, 12 808 had a documented LDL-C level of at least 130 mg/dl. Conclusion The prevalence of high-risk cardiovascular patients with therapy-resistant hypercholesterolemia is substantial in Germany.

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治疗抵抗性高胆固醇血症高危心血管患者的患病率
导论:高胆固醇血症是心血管疾病的一个因果危险因素,建议至少在高危患者中进行治疗。然而,目前缺乏流行病学数据表明,在德国有多少高危患者对大剂量他汀类药物单药治疗或他汀类药物联合其他降脂药物治疗反应不充分。方法:在IMS疾病分析数据库中来自全科医生的260多万例患者记录中,选择所有高风险心血管高胆固醇血症患者,尽管至少接受了12个月的最大降脂治疗和最佳药物供应(药物持有率≥80%),但未达到目标低密度脂蛋白-胆固醇(LDL-C)水平。结果:在实践资料的基础上,共确定602 133例接受他汀类药物单药或联合治疗且最佳药物供应(药物占有率≥80%)至少12个月的高危心血管患者。其中,49 406例患者接受了高剂量他汀类药物治疗,51 869例患者接受了任何剂量的他汀类药物与另一种降脂药的联合治疗。尽管持续接受降脂治疗,共有79848名高危患者的LDL-C水平仍未达到70 mg/dl或更低的目标;其中12808人的LDL-C水平至少为130毫克/分升。结论:在德国,高危心血管患者治疗抵抗性高胆固醇血症的患病率很高。
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