Management of hyperlipidemia in very high and extremely high-risk patients in Croatia

    Authors

    Keywords

    hyperlipidemia, secondary prevention, cardiovascular events

    DOI

    https://doi.org/10.15836/ccar2018.430

    Full Text

    Aim : An observational study was conducted to evaluate current management of elevated low-density lipoprotein cholesterol (LDL-C) in patients being treated for hyperlipidemia across central/eastern Europe and Israel. Information from this region is somewhat limited at present. Here we present data from the Croatian subpopulation. Patients and Methods: We enrolled adult patients who were receiving lipid-lowering therapy (LLT) and attending a specialist (cardiologist/diabetologist/lipidologist) or general practitioner (GP) for a routine visit at a participating academic/specialist/GP centre in Croatia. Data were collected retrospectively from patients’ records for the preceding 12 months. Patients were classified by cardiovascular risk category: Very High Risk (VHR), according to European guidelines, ( 1 , 2 ) or Extremely High Risk (EHR) according to recent American Association of Clinical Endocrinologists (AACE) criteria. ( 3 ) Results: 89 patients (all secondary prevention: VHR 41/EHR 48) were enrolled at 4 sites ( Table 1 ). All were receiving statins, as monotherapy (VHR 92.7%/EHR 83.3%) or combined with fibrates (VHR 4.9%/EHR 14.6%) or ezetimibe (VHR 2.4%/EHR 2.1%). Approximately 70% of patients in both subgroups were taking high-intensity statins (atorvastatin 40-80mg or rosuvastatin 20-40mg/day). Median (Q1, Q3) LDL-C levels were 2.5 (2.0, 3.8) mmol/L at the first, and 1.9 (1.6, 2.4) mmol/L at the last, visit of observation for VHR. Corresponding levels were 2.4 (1.7, 3.7) mmol/L and 2.1 (1.5, 3.1) mmol/L for EHR. Only 17 (41.5%; 95% CI 26.3-57.9) VHR patients and 13 (27.1%; 15.3-41.9) EHR patients had LDL-C levels within target (<1.8 mmol/L and <1.42 mmol/L, respectively). In general, the EHR group had lower median HDL-C (P <0.05) than the VHR group (e.g. 1.0 vs. 1.1 mmol/L at last visit; Table 1 ). Conclusion: Our findings indicate that a substantial proportion of VHR and EHR secondary prevention patients being treated across Croatia have LDL-C levels exceeding targets recommended in European and newer AACE guidelines. ( 1 - 3 ) Despite this, not all patients are receiving high intensity statins as recommended. Identification of EHR patients and their lipid patterns may help to optimize usage of high-intensity statin treatment, alone or in combination with newer treatments, for better control of elevated
LDL-C.

    Cardiologia Croatica
    Back to search

    Management of hyperlipidemia in very high and extremely high-risk patients in Croatia

    Extended Abstract
    Issue11-12
    Published
    Pages430-431
    PDF via DOIhttps://doi.org/10.15836/ccar2018.430
    hyperlipidemia
    secondary prevention
    cardiovascular events

    Authors

    Hrvoje Pintarić*ORCIDFaculty of Dentistry, Zagreb, Croatia
    Marijana Knezović FlorijanORCIDFaculty of Dentistry, Zagreb, Croatia
    Ian BridgesORCIDFaculty of Dentistry, Zagreb, Croatia
    Robert SteinerORCIDFaculty of Dentistry, Zagreb, Croatia
    Luka ZaputovićORCIDFaculty of Dentistry, Zagreb, Croatia
    Davor MiličićORCIDFaculty of Dentistry, Zagreb, Croatia

    Full Text

    Aim : An observational study was conducted to evaluate current management of elevated low-density lipoprotein cholesterol (LDL-C) in patients being treated for hyperlipidemia across central/eastern Europe and Israel. Information from this region is somewhat limited at present. Here we present data from the Croatian subpopulation. Patients and Methods: We enrolled adult patients who were receiving lipid-lowering therapy (LLT) and attending a specialist (cardiologist/diabetologist/lipidologist) or general practitioner (GP) for a routine visit at a participating academic/specialist/GP centre in Croatia. Data were collected retrospectively from patients’ records for the preceding 12 months. Patients were classified by cardiovascular risk category: Very High Risk (VHR), according to European guidelines, ( 1 , 2 ) or Extremely High Risk (EHR) according to recent American Association of Clinical Endocrinologists (AACE) criteria. ( 3 ) Results: 89 patients (all secondary prevention: VHR 41/EHR 48) were enrolled at 4 sites ( Table 1 ). All were receiving statins, as monotherapy (VHR 92.7%/EHR 83.3%) or combined with fibrates (VHR 4.9%/EHR 14.6%) or ezetimibe (VHR 2.4%/EHR 2.1%). Approximately 70% of patients in both subgroups were taking high-intensity statins (atorvastatin 40-80mg or rosuvastatin 20-40mg/day). Median (Q1, Q3) LDL-C levels were 2.5 (2.0, 3.8) mmol/L at the first, and 1.9 (1.6, 2.4) mmol/L at the last, visit of observation for VHR. Corresponding levels were 2.4 (1.7, 3.7) mmol/L and 2.1 (1.5, 3.1) mmol/L for EHR. Only 17 (41.5%; 95% CI 26.3-57.9) VHR patients and 13 (27.1%; 15.3-41.9) EHR patients had LDL-C levels within target (<1.8 mmol/L and <1.42 mmol/L, respectively). In general, the EHR group had lower median HDL-C (P <0.05) than the VHR group (e.g. 1.0 vs. 1.1 mmol/L at last visit; Table 1 ). Conclusion: Our findings indicate that a substantial proportion of VHR and EHR secondary prevention patients being treated across Croatia have LDL-C levels exceeding targets recommended in European and newer AACE guidelines. ( 1 - 3 ) Despite this, not all patients are receiving high intensity statins as recommended. Identification of EHR patients and their lipid patterns may help to optimize usage of high-intensity statin treatment, alone or in combination with newer treatments, for better control of elevated
LDL-C.