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Valoración del riesgo aterogénico. ¿Lo podemos mejorar? 致动脉粥样硬化风险评估--我们能改进它吗?
IF 1.6 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-01-01 DOI: 10.1016/j.arteri.2024.01.001
José Puzo Foncillas
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引用次数: 0
Widespread xanthomas regression by personalized lipid lowering therapy in heterozygous familial hypercholesterolemia 个体化降脂治疗在杂合子家族性高胆固醇血症中广泛的黄瘤消退。
IF 1.6 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-01-01 DOI: 10.1016/j.arteri.2023.11.002
Francesco Sbrana, Beatrice Dal Pino, Federico Bigazzi, Tiziana Sampietro

“The lower, the better” is the recommended approach in the management of high LDL cholesterol. Unfortunately, this does not always achieve as in the case of a 69-year-old woman referred to our Institute for her lipid profile (LDL cholesterol 412 mg/dl), bilateral xanthelasma and cutaneous xanthomas. With a maximized and personalized lipid-lowering therapies (rosuvastatin, ezetimibe, PCSK9i and lipoprotein apheresis), after only six months, the patient showed an impressive regression in her cutaneous xanthomas.

“越低越好”是治疗高LDL胆固醇的推荐方法。不幸的是,这并不总是能够实现,例如一位69岁的女性因其脂质谱(低密度脂蛋白胆固醇412mg/dl)、双侧黄斑瘤和皮肤黄斑瘤而来到我们研究所。通过最大化和个性化的降脂治疗(瑞舒伐他汀、依泽替米贝、PCSK9i和脂蛋白分离),仅仅6个月后,患者的皮肤黄瘤出现了令人印象深刻的消退。
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引用次数: 0
Nuevo índice aterogénico para la predicción de aterosclerosis carotídea basado en la ratio proteína C reactiva no ultrasensible/HDL 基于非超敏 C 反应蛋白/高密度脂蛋白比值的新动脉粥样硬化预测指数
IF 1.6 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-01-01 DOI: 10.1016/j.arteri.2023.07.002
Óscar Fabregat-Andrés , Pilar Pérez-de-Lucía , Victor E. Vallejo-García , Pablo Vera-Ivars , Alfonso A. Valverde-Navarro , José María Tormos

Introduction

Current guidelines recommend cardiovascular risk assessment as a preventive measure for cardiovascular diseases, whose fundamental etiology is arteriosclerosis. One of the tools used to estimate risk in clinical practice are atherogenic indices (AI), ratios between lipid fractions with well-established reference ranges. Despite its widespread use, there is still limited information on its clinical utility. In recent years, some research has reinforced the role of inflammation in the etiology and chronicity of the atherosclerotic process. The inclusion of inflammatory parameters in the AI calculation could improve its diagnostic performance in the detection of arteriosclerosis. We sought to evaluate a new AI as a ratio between C-reactive protein (CRP) values and high-density lipoprotein cholesterol (HDL) values.

Methods

A total of 282 asymptomatic patients with no history of cardiovascular disease were included in the study. Laboratory tests with lipid profile and CRP, and carotid ultrasound to assess the presence of atheromatosis were performed in all of them. The new AI is established as the ratio between non-ultrasensitive CRP value in mg/dL (multiplied by 100) and HDL value in mg/dL. It was compared with the Castelli I and II indices, and the plasma atherogenic index. The optimal cut-off point of the new AI was value = 1 as determined by ROC curve, with an area under the curve of 0.678 (95% CI 0.60-0.75; p < 0.001).

Results

Mean age of patients was 60.4 ± 14.5 years. A total of 118 patients (41.8% of total) had carotid arteriosclerosis. When evaluating the diagnostic performance of different AIs, we found that CRP·100/HDL ratio showed the highest values of sensitivity and positive predictive value (0.73 and 0.68, respectively) compared to the Castelli I and II indices, and the plasma atherogenic index. It was also the only predictor of carotid atheromatosis both when considering its values quantitatively (with OR 1.4 [95% CI 1.1-1.7]; p = 0.005), and qualitatively (with OR 2.9 [95% CI 1.5-5.5]; p < 0.001) in patients with a CRP·100/HDL ratio > 1.

Conclusions

The new PCR·100/HDL index showed the best diagnostic performance in the detection of carotid atheromatosis compared to other classic AIs in this Spanish population of asymptomatic patients.

导言:现行指南建议将心血管风险评估作为心血管疾病的预防措施,而心血管疾病的根本病因是动脉硬化。在临床实践中,用于评估风险的工具之一是致动脉粥样硬化指数(AI),即具有明确参考范围的脂质组分之间的比率。尽管其应用广泛,但有关其临床实用性的信息仍然有限。近年来,一些研究强化了炎症在动脉粥样硬化病因和慢性过程中的作用。将炎症参数纳入 AI 计算可提高其在动脉硬化检测中的诊断性能。我们试图评估一种新的 AI,即 C 反应蛋白(CRP)值与高密度脂蛋白胆固醇(HDL)值之间的比值。研究共纳入 282 名无症状、无心血管疾病史的患者,对他们全部进行了血脂和 CRP 实验室检测,并进行了颈动脉超声检查以评估是否存在动脉粥样硬化。新的 AI 值是以毫克/分升为单位的非超敏 CRP 值(乘以 100)与以毫克/分升为单位的 HDL 值之间的比值。它与卡斯特里 I 和 II 指数以及血浆致动脉粥样硬化指数进行了比较。结果 患者平均年龄为(60.4 ± 14.5)岁。共有 118 名患者(占总数的 41.8%)患有颈动脉硬化。在评估不同 AI 的诊断性能时,我们发现 CRP-100/HDL 比值的敏感性和阳性预测值(分别为 0.73 和 0.68)与 Castelli I 和 II 指数以及血浆致动脉粥样硬化指数相比最高。从定量(OR 1.4 [95% CI 1.1-1.7];P = 0.005)和定性(OR 2.9 [95% CI 1.5-5.5];P < 0.结论在西班牙无症状患者群体中,与其他经典 AI 相比,新的 PCR-100/HDL 指数在检测颈动脉粥样硬化方面显示出最佳诊断性能。
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引用次数: 0
Perfil clínico de la hipercolesterolemia severa en 156.000 adultos en atención primaria 156000名初级保健成人严重高胆固醇血症的临床特征。
IF 1.6 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-01-01 DOI: 10.1016/j.arteri.2023.08.002
Teresa Gijón-Conde , Carolina Ferré Sánchez , Isabel Ibáñez Delgado , Berenice Rodríguez Jiménez , José R. Banegas

Objective

To examine the frequency of severe hypercholesterolemia (HS) and its clinical profile, and the phenotype of familial hypercholesterolemia (FH), in the primary-care setting in a large health area of the Community of Madrid (CAM).

Material and methods

Multicenter study of subjects with a health card assigned to 69 health centers (Northwest/CAM area). HS was defined as cholesterol ≥ 300 mg/dL or LDL-cholesterol ≥ 220 mg/dL in any analysis performed (1-1-2018 to 12-30-2021); and FH phenotype as c-LDL ≥ 240 mg/dL (≥ 160 mg/dL if lipid-lowering treatment) with triglycerides < 200 mg/dL and TSH < 5 μIU/mL.

Results

156,082 adults ≥ 18 years with an available lipid profile were analyzed. 6187 subjects had HS (3.96% of the laboratory tests studied, 95% CI: 3.87-4.06%). The mean evolution time of the diagnosis of hyperlipidemia in the computerized clinical record was 10.8 years, 36.5% had hypertension, 9.5% diabetes and 62.9% overweight/obesity. 83.7% were taking lipid-lowering drugs (65.7% low/moderate and 28.6% high/very high intensity). 6.1% had cardiovascular disease (94.2% treated with lipid-lowering agents), with LDL-cholesterol < 55, < 70 and < 100 mg/dL of 1.8%, 5.8% and 20.2%, respectively (vs. 1%, 2.3% and 11.2% if no cardiovascular disease). 1600 subjects had FH phenotype (95% CI: 1.03%, 0.98-1.08%).

Conclusions

Four out of 100 patients analyzed in primary care have HS, with high treatment level, but insufficient intensity, and poor achievement of treatment goals. One in 100 have the FH phenotype. The identification of both dyslipidemias by computerized records would allow their more precise and early detection and establish cardiovascular preventive strategies.

目的:在马德里社区(CAM)的一个大型卫生区的初级保健环境中,检查严重高胆固醇血症(HS)的频率及其临床特征和家族性高胆固醇血症的表型。材料和方法:对69个卫生中心(西北/CAM区)的健康卡受试者进行多中心研究。在任何分析中,HS被定义为胆固醇≥300mg/dL或LDL胆固醇≥220mg/dL(2018年1月1日至2021年12月30日);FH表型为c-LDL≥240mg/dL(如果降脂治疗,则≥160mg/dL)和甘油三酯。6187名受试者患有HS(占所研究实验室测试的3.96%,95%CI:3.87-4.06%)。计算机临床记录中诊断高脂血症的平均演变时间为10.8年,36.5%患有高血压,9.5%患有糖尿病,62.9%超重/肥胖。83.7%的患者服用降脂药物(65.7%为低强度/中等强度,28.6%为高强度/极高强度)。6.1%患有心血管疾病(94.2%接受降脂药物治疗),伴有低密度脂蛋白胆固醇。结论:在初级保健分析的100名患者中,有4名患有HS,治疗水平高,但强度不足,治疗目标实现率低。每100人中就有1人具有FH表型。通过计算机记录识别这两种血脂异常将使其能够更准确、早期地检测,并制定心血管预防策略。
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引用次数: 0
Sueño y riesgo cardiometabólico. Revisión narrativa 睡眠与心脏代谢风险叙述性综述
IF 1.6 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-01-01 DOI: 10.1016/j.arteri.2023.08.001
J. Ildefonzo Arocha Rodulfo , Gestne Aure Fariñez , Fernando Carrera

Objectives

Sleep disturbances, including disrupted sleep and short sleep duration, are highly prevalent and are prospectively associated with an increased risk for various chronic diseases, including cardiometabolic, neurodegenerative, and autoimmune diseases.

Material and methods

This is a narrative review of the literature based on numerous articles published in peer-reviewed journals since the beginning of this century.

Results

The relationship between sleep disorders and metabolic dysregulation has been clearly established, mainly in the setting of modern epidemic of cardiometabolic disease, a cluster of conditions include obesity, insulin resistance, arterial hypertension, and dyslipidaemia, all of them considered as main risk factor for atherosclerotic cardiovascular disease (ACVD) and its clinical expression such as ischemic ictus, myocardial infarction and type 2 diabetes. Clinically viable tools to measure sleep duration and quality are needed for routine screening and intervention.

Conclusions

In view of what has been exposed in this review, it is evident that the timing, amount, and quality of sleep are critical to reduce the burden of risk factors for several chronic disease, including ACVD and type 2 diabetes, and most relevant in young people. Future research studies should elucidate the effectiveness of multimodal interventions to counteract the risk of short sleep for optimal patient outcomes across the healthcare continuum, especially in young people.

目的睡眠障碍(包括睡眠中断和睡眠时间短)的发病率很高,而且与各种慢性疾病(包括心脏代谢疾病、神经退行性疾病和自身免疫性疾病)的发病风险增加密切相关。结果睡眠障碍与新陈代谢失调之间的关系已得到明确证实,这主要是在现代心血管代谢疾病流行的背景下发生的,这些疾病包括肥胖、胰岛素抵抗、动脉高血压和血脂异常,它们都被认为是动脉粥样硬化性心血管疾病(ACVD)及其临床表现(如缺血性心肌梗塞、心肌梗死和 2 型糖尿病)的主要危险因素。结论 综上所述,睡眠的时间、数量和质量对于减轻包括 ACVD 和 2 型糖尿病在内的多种慢性疾病的风险因素负担至关重要,这一点在年轻人中尤为突出。未来的研究应阐明多模式干预措施的有效性,以抵消睡眠时间过短的风险,从而在整个医疗保健过程中为患者(尤其是年轻人)提供最佳治疗效果。
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引用次数: 0
Análisis del programa de apoyo al paciente de evolocumab (Repatha®) para pacientes con enfermedades cardiovasculares en Colombia 哥伦比亚心血管疾病患者evolocumab (Repatha®)患者支持计划分析
IF 1.6 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-11-01 DOI: 10.1016/j.arteri.2023.04.005
Ángel Alberto García-Peña , Mariana Pineda-Posada , Carol Páez-Canro , César Cruz , Daniel Samacá-Samacá

Background

Cardiovascular diseases are considered the leading cause of death globally. This study describes the demographic characteristics, treatment patterns, self-reported compliance and persistence, and to explore variables related to non-adherence of patients enrolled in the cardiovascular patient support program (PSP) for evolocumab treatment in Colombia.

Methods

This retrospective observational of the data registry of patients who entered the evolocumab PSP program.

Results

The analysis included 930 patients enrolled in the PSP (2017-2021). Mean age was 65.1 (SD ± 13.1) and49.1% patients were female. The mean compliance rate to evolocumab treatment was 70.5% (SD ± 21.8). A total of 367 patients (40.5%) reported compliance higher than 80%. Persistence analysis included 739 patients (81.5%) where 87.8% of these patients were considered persistent to treatment. A total of 871 patients (93.7%) reported the occurrence of at least one adverse event during the follow-up period (mostly non-serious).

Conclusion

This is the first real-life study describing patient characteristics, compliance and continuity of treatment for dyslipidemia in a patient support program in Colombia. The overall adherence found was higher than 70%; similar to findings reported in other real-life studies with iPCSK9. However, the reasons for low compliance were different, highlighting the high number of administrative and medical reasons for suspension or abandonment of treatment with evolocumab.

背景:心血管疾病被认为是全球死亡的主要原因。本研究描述了人口统计学特征、治疗模式、自我报告的依从性和持久性,并探索与哥伦比亚心血管患者支持计划(PSP)中evolocumab治疗的患者不依从性相关的变量。方法回顾性观察进入evolocumab PSP项目的患者的注册数据。结果该分析包括930名参与PSP(2017-2021)的患者。平均年龄为65.1 (SD±13.1)岁,女性占49.1%。evolocumab治疗的平均依从率为70.5% (SD±21.8)。367例患者(40.5%)的依从性高于80%。持续性分析纳入739例患者(81.5%),其中87.8%的患者被认为坚持治疗。共有871例患者(93.7%)报告在随访期间至少发生一次不良事件(多为非严重事件)。结论:这是哥伦比亚患者支持项目中第一个描述血脂异常患者特征、依从性和治疗连续性的现实研究。总体依从性高于70%;与iPCSK9在现实生活中的其他研究结果相似。然而,低依从性的原因各不相同,突出表明暂停或放弃evolocumab治疗的行政和医学原因较多。
{"title":"Análisis del programa de apoyo al paciente de evolocumab (Repatha®) para pacientes con enfermedades cardiovasculares en Colombia","authors":"Ángel Alberto García-Peña ,&nbsp;Mariana Pineda-Posada ,&nbsp;Carol Páez-Canro ,&nbsp;César Cruz ,&nbsp;Daniel Samacá-Samacá","doi":"10.1016/j.arteri.2023.04.005","DOIUrl":"10.1016/j.arteri.2023.04.005","url":null,"abstract":"<div><h3>Background</h3><p>Cardiovascular diseases are considered the leading cause of death globally. This study describes the demographic characteristics, treatment patterns, self-reported compliance and persistence, and to explore variables related to non-adherence of patients enrolled in the cardiovascular patient support program (PSP) for evolocumab treatment in Colombia.</p></div><div><h3>Methods</h3><p>This retrospective observational of the data registry of patients who entered the evolocumab PSP program.</p></div><div><h3>Results</h3><p>The analysis included 930 patients enrolled in the PSP (2017-2021). Mean age was 65.1 (SD<!--> <!-->±<!--> <!-->13.1) and49.1% patients were female. The mean compliance rate to evolocumab treatment was 70.5% (SD<!--> <!-->±<!--> <!-->21.8). A total of 367 patients (40.5%) reported compliance higher than 80%. Persistence analysis included 739 patients (81.5%) where 87.8% of these patients were considered persistent to treatment. A total of 871 patients (93.7%) reported the occurrence of at least one adverse event during the follow-up period (mostly non-serious).</p></div><div><h3>Conclusion</h3><p>This is the first real-life study describing patient characteristics, compliance and continuity of treatment for dyslipidemia in a patient support program in Colombia. The overall adherence found was higher than 70%; similar to findings reported in other real-life studies with iPCSK9. However, the reasons for low compliance were different, highlighting the high number of administrative and medical reasons for suspension or abandonment of treatment with evolocumab.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"35 6","pages":"Pages 280-289"},"PeriodicalIF":1.6,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9935001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Percepción de los médicos frente al consumo de vino tinto y la salud cardiovascular 医生对红酒消费与心血管健康的看法
IF 1.6 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-11-01 DOI: 10.1016/j.arteri.2023.05.002
Javier Espíldora-Hernández , Salvador Martín-Cortés , María José Benítez-Toledo , Inmaculada Coca-Prieto , Miguel Ángel. Sánchez-Chaparro , Pedro Valdivielso

Introduction

The consumption of red wine has historically been associated with a reduction in cardiovascular risk, with sometimes controversial scientific evidence.

Method

A survey was carried out via whatsapp dated 09/01/22 to a cohort of doctors from the province of Malaga, asking about possible healthy red wine consumption habits, differentiating: never, 3-4 glasses per week, 5 -6 weekly drinks and one daily drink.

Results

A total of 184 physicians answered, with a mean age of 35 years ± 11.1, of which 84 (45.6%) were women, distributed in different specialties, the majority being internal medicine with 52 (28.2%). The most frequently chosen option was D (59.2%), followed by A (21.2%), C (14.7%) and B (5%).

Conclusions

More than half of the doctors surveyed recommended zero consumption, and only 20% indicated that a daily drink could be healthy in non-drinkers.

从历史上看,饮用红酒与降低心血管风险有关,但有时科学证据存在争议。方法通过whatsapp于22年9月1日对马拉加省的一组医生进行了一项调查,询问他们可能的健康红酒消费习惯,区分为:从不喝、每周喝3-4杯、每周喝5 -6杯和每天喝一次。结果共184名受访医师,平均年龄(35岁±11.1岁),其中女性84人(45.6%),分布在不同专科,以内科为主,52人(28.2%)。选择最多的选项是D(59.2%),其次是A(21.2%)、C(14.7%)和B(5%)。超过一半的受访医生建议不要饮酒,只有20%的医生表示不饮酒者每天喝一杯酒是有益健康的。
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引用次数: 0
Long-term treatment persistence and maintained reduction of LDL-cholesterol levels with evolocumab over 30 months: Results from the Spanish cohort of the European prospective HEYMANS study evolocumab在30个月的长期治疗中持续降低ldl -胆固醇水平:来自欧洲前瞻性HEYMANS研究的西班牙队列结果
IF 1.6 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-11-01 DOI: 10.1016/j.arteri.2023.04.004
Agustín Blanco Echevarría , Juan De Dios García Díaz , Assumpta Caixas , Núria Plana Gil , Miguel Ángel Rico Corral , Ian Bridges , Nafeesa Dhalwani , Sònia Gatell Menchen , Kausik K. Ray
<div><h3>Aims</h3><p>Limited data exist on low-density lipoprotein-cholesterol (LDL-C) level variability or long-term persistence with the monoclonal antibody evolocumab in routine clinical practice. HEYMANS (<span>NCT02770131</span><svg><path></path></svg>) is the first multi-country, multicenter, observational study of European patients initiating evolocumab as part of their routine clinical management, based on local reimbursement criteria (overall data recently published). The aim of this analysis is to describe clinical characteristics, baseline and changes in LDL-C levels, treatment patterns and persistence to evolocumab over 30 months in the Spanish cohort using data from the HEYMANS Registry.</p></div><div><h3>Methods</h3><p>HEYMANS was a prospective study of adult patients (≥18 years) who received at least one dose of evolocumab. A total of 1951 patients were enrolled from 12 countries and were followed up for 30 months after evolocumab initiation. Data were collected for 6 months before evolocumab initiation and up to 30 months thereafter. The Spanish cohort included patients who started evolocumab in routine clinical practice from March 2016 to September 2019. Demographic and clinical characteristics, lipid-lowering therapies (LLT), and lipid levels were collected.</p></div><div><h3>Results</h3><p>In total, 201 patients were included in the Spanish cohort. Median follow-up (Q1–Q3) was 30.0 (12–30) months. A total of 61.7% of patients were men and the mean (standard deviation) age was 59.5 (10.8) years. Most patients (68.7%) had experienced a prior cardiovascular event, 45.3% had coronary artery disease or stable angina, and 60.2% had a diagnosis of familial hypercholesterolemia. Overall, 57.7% of patients were receiving treatment with statins, most of them with high-intensity statins (85.3%); 45.8% of patients were intolerant to statins, and 26.4% of patients did not receive any LLT. At baseline, median (Q1–Q3) LDL-C levels were 151 (123–197) mg/dL. After 3 months of treatment, baseline LDL-C decreased by 66% to a median of 50 (30–83) mg/dL and these levels were maintained over time, with a median LDL-C of 55 (40–99) mg/dL at 30 months. At months 10–12 of treatment, LDL-C levels<!--> <!--><<!--> <!-->55<!--> <!-->mg/dL were achieved by 56.3% of patients. LDL-C levels<!--> <!--><<!--> <!-->70<!--> <!-->mg/dL were achieved by 70.1% of patients, and a lowering of LDL-C levels ≥50% was achieved by 76.8% of patients. The percentage of patients on evolocumab treatment was 95% at 12 months and 93% at 30 months.</p></div><div><h3>Conclusions</h3><p>In the Spanish cohort in routine clinical practice, evolocumab therapy provided a reduction in LDL-C levels consistent with that reported in previous clinical trials, which was sustained during 30 months of follow-up. Treatment with evolocumab was started at LDL-C levels 50% higher than those recommended by The Spanish Society of Arteriosclerosis and the Therapeutic Positioning Report. The pro
目的:在常规临床实践中,单克隆抗体evolocumab的低密度脂蛋白-胆固醇(LDL-C)水平变异性或长期持久性的数据有限。HEYMANS (NCT02770131)是首个多国、多中心、观察性研究,研究对象是欧洲患者,根据当地的报销标准,将evolocumab作为其常规临床管理的一部分。本分析的目的是描述临床特征、基线和LDL-C水平的变化、治疗模式和evolocumab在西班牙队列中超过30个月的持续使用,数据来自HEYMANS Registry。sheymans是一项前瞻性研究,研究对象是接受至少一剂evolocumab治疗的成年患者(≥18岁)。共有来自12个国家的1951名患者入组,并在evolocumab启动后随访30个月。evolocumab起始治疗前6个月和起始治疗后最多30个月收集数据。西班牙队列包括2016年3月至2019年9月在常规临床实践中开始使用evolocumab的患者。收集人口统计学和临床特征、降脂疗法(LLT)和血脂水平。结果西班牙队列共纳入201例患者。中位随访(Q1-Q3)为30.0(12-30)个月。61.7%的患者为男性,平均(标准差)年龄为59.5(10.8)岁。大多数患者(68.7%)既往有心血管事件,45.3%有冠状动脉疾病或稳定型心绞痛,60.2%诊断为家族性高胆固醇血症。总体而言,57.7%的患者正在接受他汀类药物治疗,其中大部分是高强度他汀类药物(85.3%);45.8%的患者对他汀类药物不耐受,26.4%的患者未接受任何LLT治疗。基线时,中位(Q1-Q3) LDL-C水平为151 (123-197)mg/dL。治疗3个月后,基线LDL-C下降了66%,中位数为50 (30 - 83)mg/dL,并且随着时间的推移这些水平保持不变,30个月时中位数LDL-C为55 (40-99)mg/dL。在治疗10-12个月时,LDL-C水平<56.3%的患者达到55 mg/dL。LDL-C水平<70.1%的患者达到70mg /dL, 76.8%的患者达到LDL-C水平降低≥50%。接受evolocumab治疗的患者百分比在12个月时为95%,在30个月时为93%。在常规临床实践中的西班牙队列中,evolocumab治疗提供了与先前临床试验报告一致的LDL-C水平降低,并持续了30个月的随访。evolocumab治疗开始时LDL-C水平比西班牙动脉硬化学会和治疗定位报告推荐的水平高50%。通过联合治疗,达到2019年ESC/EAS LDL-C目标的可能性将会提高,并且在开始使用evolocumab时,LDL-C阈值也会降低。在随访期间,evolocumab的持续性仍然很高,停药的百分比非常低(12个月时为5%;30个月为7%)。
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引用次数: 0
Estudio observacional de pacientes de una Unidad de Lípidos en tratamiento hipolipemiante para prevención primaria y secundaria: Estudio ULFI 一单位脂类患者一级和二级预防降脂治疗的观察性研究:ULFI研究
IF 1.6 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-11-01 DOI: 10.1016/j.arteri.2023.06.002
Àlex Vila , Estel Pons , Patricia Trinidad García , Daniel Vidal , Sara López , Armand Grau

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.

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岁及以上、在脂质科接受一级或二级预防降脂治疗的患者。结果根据2019年指南,62.1%的患者心血管风险极高(CVR),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%根据2019年指南实现了LDLc的充分控制,20%根据2021年指南实现了LDLc的充分控制。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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引用次数: 0
EL VINO: ¿ES REALMENTE SALUDABLE? 葡萄酒:真的健康吗?
IF 1.6 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-11-01 DOI: 10.1016/j.arteri.2023.11.001
Ramón Estruch
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Clinica e Investigacion en Arteriosclerosis
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