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Nutr Metab Cardiovasc Dis ; 34(7): 1670-1680, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38664125

RESUMO

BACKGROUND: Atherosclerotic cardiovascular disease (ASCVD) is the most common cause of death in Europe. Although the 2019 European Society of Cardiology/European Atherosclerosis Society Guidelines for the management of dyslipidaemias claim a target low-density lipoprotein cholesterol (LDL-C) value of <55 mg/dL for very high-risk patients by use of lipid-lowering therapy (LLT) and lifestyle adaptations, the target level achievement is not satisfactory. We examined LLT use in ASCVD patients exceeding LDL-C target levels at admission and its adaptations at discharge. METHODS AND RESULTS: Between January 2017 and February 2020, 1091 patients with LDL-C >100 mg/dL and ASCVD defined as diagnosis of angina pectoris (AP, n = 179), acute myocardial infarction (AMI, n = 317), chronic ischemic heart disease (CHD, n = 195), or peripheral artery disease (PAD, n = 400) were extracted from hospital records. LLT use on admission and discharge as well as recommendations on lifestyle and nutrition were analysed. On admission, 51% of the patients were not taking LLT. At discharge, 91% were prescribed statins and 87% were advised on lifestyle adaptation and/or pharmacological treatment. High-intensity statin use at discharge was present in 63% of the AP-group, 92% of the AMI-group, 62% of the CHD-group and 71% of the PAD-group. Ezetimibe was present in 16% and proprotein convertase subtilisin/kexin 9 inhibitors (PCSK9i) in 1%. However, of those on high-intensity statin, 25% remained on insufficient statin dosage. CONCLUSION: Switch to high-intensity statins and use of ezetimibe and PCSK9i was low in chronic ASCVD patients. Even though statin intake was high in high-risk patients, target levels were still not reached.


Assuntos
Aterosclerose , Biomarcadores , LDL-Colesterol , Dislipidemias , Humanos , Masculino , Feminino , Estudos Retrospectivos , Idoso , Pessoa de Meia-Idade , Dislipidemias/tratamento farmacológico , Dislipidemias/sangue , Dislipidemias/diagnóstico , Dislipidemias/epidemiologia , Biomarcadores/sangue , LDL-Colesterol/sangue , Medição de Risco , Aterosclerose/sangue , Aterosclerose/diagnóstico , Aterosclerose/tratamento farmacológico , Aterosclerose/epidemiologia , Aterosclerose/prevenção & controle , Resultado do Tratamento , Fatores de Tempo , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Fatores de Risco de Doenças Cardíacas , Alta do Paciente , Admissão do Paciente , Comportamento de Redução do Risco , Inibidores de PCSK9 , Fatores de Risco , Hipolipemiantes/uso terapêutico , Idoso de 80 Anos ou mais , Padrões de Prática Médica , Pró-Proteína Convertase 9
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