Araştırma Makalesi
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Yıl 2024, Cilt: 51 Sayı: 1, 10 - 18, 14.03.2024
https://doi.org/10.5798/dicletip.1451412

Öz

Kaynakça

  • 1.Presta V, Figliuzzi I, Miceli F, et al. Achievement oflow density lipoprotein (LDL) cholesterol targets inprimary and secondary prevention: Analysis of a largereal practice database in Italy. Atherosclerosis.2019;285:40-8.doi:10.1016/j.atherosclerosis.2019.03.017
  • 2.Behbodikhah J, Ahmed S, Elyasi A, et al.Apolipoprotein B and Cardiovascular Disease:Biomarker and Potential Therapeutic Target.Metabolites. 2021;11(10):690.doi:10.3390/metabo11100690
  • 3.Scott C, Lateef SS, Hong CG, et al. Inflammation,coronary plaque progression, and statin use: Asecondary analysis of the Risk Stratification withImage Guidance of HMG CoA Reductase InhibitorTherapy (RIGHT) study. Clin Cardiol. 2022;45(6):622-8.doi:10.1002/clc.23808
  • 4.Westman EC. A review of decision aids to assesscardiovascular risk. Curr Opin Endocrinol DiabetesObes. 2022;29(5):420-6.doi:10.1097/MED.0000000000000760
  • 5.Sarsam S, Berry A, Degheim G, et al. Real-world useof PCSK9 inhibitors: A single-center experience. J IntMed Res. 2019;47(1):265-70.doi:10.1177/0300060518800595
  • 6.Mach F, Baigent C, Catapano AL, et al. 2019 ESC/EASGuidelines for the management of dyslipidaemias: lipidmodification to reduce cardiovascular risk [publishedcorrection appears in Eur Heart J. 2020 Nov21;41(44):4255]. Eur Heart J. 2020;41(1):111-88.doi:10.1093/eurheartj/ehz455
  • 7.Vallejo-Vaz AJ, Bray S, Villa G, et al. Implications ofACC/AHA Versus ESC/EAS LDL-C Recommendationsfor Residual Risk Reduction in ASCVD: A SimulationStudy From DA VINCI [published online ahead of print, 2022 May 14]. Cardiovasc Drugs Ther.2022;10.1007/s10557-022-07343-x.doi:10.1007/s10557-022-07343-x
  • 8.Klug EQ, Raal FJ. New cholesterol targets for patientsat high or very high cardiovascular risk and theindications for PCSK9 inhibitors. S Afr Med J.2020;110(11):13126.doi:10.7196/SAMJ.2020.v110i11.15191
  • 9.Mc Namara K, Alzubaidi H, Jackson JK.Cardiovascular disease as a leading cause of death:how are pharmacists getting involved? Integr PharmRes Pract. 2019;8:1-11. doi:10.2147/IPRP.S133088
  • 10.Murphy MJ, Grundy EMD. Slowdown in MortalityImprovement in the Past Decade: A US/UKComparison. J Gerontol B Psychol Sci Soc Sci.2022;77(Suppl_2):S138-S147.doi:10.1093/geronb/gbab220
  • 11. Zhang Y, Pletcher MJ, Vittinghoff E, et al. AssociationBetween Cumulative Low-Density LipoproteinCholesterol Exposure During Young Adulthood andMiddle Age and Risk of Cardiovascular Events. JAMA Cardiol. 2021;6(12):1406-13.doi:10.1001/jamacardio.2021.3508
  • 12.Pedersen TR. Randomised trial of cholesterollowering in 4444 patients with coronary heart disease:the Scandinavian Simvastatin Survival Study (4S).Lancet. 1994;344:1383- 9.https://doi.org/10.1016/S0140-6736(94)90566-5
  • 13.Sacks FM, Pfeffer MD, Moye LA, et al. The Effect ofPravastatin on Coronary Events after MyocardialInfarction in Patients with Average Cholesterol Levels.N Engl J Med. 1996;335:1001-9.https://doi.org/10.1056/ NEJM199610033351401
  • 14.Cannon CP, Blazing MA, Giugliano RP, et al.Ezetimibe added to statin therapy after acute coronary syndromes. N Engl J Med. 2015;372:2387-97.https://doi.org/10.1056/ NEJMoa1410489
  • 15.Cholesterol Treatment Trialists’ (CTT)Collaboration. Baigent C, Blackwell L, Emberson J, et al.Efficacy and safety of more intensive lowering of C-LDLcholesterol: a meta-analysis of data from 170 000participants in 26 randomized trials. Lancet. 2010;376: 1670-81.https://doi.org/10.1016/S0140-6736(10)61350-5
  • 16.Cannon CP, Braunwald E, McCabe CH, et al.Intensive versus moderate lipid lowering with statinsafter acute coronary syndromes. N Engl J Med. 2004;350: 1495-504.https://doi.org/10.1056/NEJMoa040583
  • 17.Lee YJ, Cho JY, You SC, et al. Moderate-intensitystatin with ezetimibe vs. high-intensity statin inpatients with diabetes and atheroscleroticcardiovascular disease in the RACING trial. Eur Heart J. 2023;44(11):972-83. doi:10.1093/eurheartj/ehac709
  • 18.Warden BA, Fazio S, Shapiro MD. The PCSK9revolution: Current status, controversies, and futuredirections. Trends Cardiovasc Med. 2020;30(3):179-85.doi:10.1016/j.tcm.2019.05.007
  • 19.Gunta SP, O'Keefe JH, O'Keefe EL, et al. PCSK9inhibitor, ezetimibe, and bempedoic acid: Evidence-based therapies for statin-intolerant patients[published online ahead of print, 2023 Mar 3]. ProgCardiovasc Dis. 2023;S0033-0620(23)00013-0.doi:10.1016/j.pcad.2023.02.007
  • 20.Giugliano RP, Keech A, Murphy SA, et al. ClinicalEfficacy and Safety of Evolocumab in High-RiskPatients Receiving a Statin: Secondary Analysis ofPatients With Low LDL Cholesterol Levels and in Those Already Receiving a Maximal-Potency Statin in aRandomized Clinical Trial. JAMA Cardiol.2017;2(12):1385-91.doi:10.1001/jamacardio.2017.3944
  • 21.Gencer B, Mach F, Guo J, et al. Cognition AfterLowering LDL-Cholesterol With Evolocumab. J Am CollCardiol. 2020;75(18):2283-93.doi:10.1016/j.jacc.2020.03.039
  • 22. Damask A, Steg PG, Schwartz GG, et al. Patients With High Genome-Wide Polygenic Risk Scores for Coronary Artery Disease May Receive Greater Clinical BenefitFrom Alirocumab Treatment in the ODYSSEYOUTCOMES Trial. Circulation. 2020;141(8):624-36. doi:10.1161/CIRCULATIONAHA.119.044434
  • 23.Virani SS, Smith SC Jr, Stone NJ, et al. SecondaryPrevention for Atherosclerotic Cardiovascular Disease:Comparing Recent US and European Guidelines onDyslipidemia. Circulation. 2020;141(14):1121-3.doi:10.1161/CIRCULATIONAHA.119.044282
  • 24.Sabouret P, Lemesle G, Bellemain-Appaix A, et al.Post-discharge and long-term follow-up after an acutecoronary syndrome: International Collaborative Groupof CNCF position paper. Arch Med Sci. 2022;18(4):839-54.doi:10.5114/aoms/150321
  • 25. Pedretti RFE, Hansen D, Ambrosetti M, et al. How to optimize the adherence to a guideline-directed medical therapy in the secondary prevention of cardiovasculardiseases: a clinical consensus statement from theEuropean Association of Preventive Cardiology. Eur JPrev Cardiol. 2023;30(2):149-66.doi:10.1093/eurjpc/zwac204
  • 26.Cosin-Sales J, Sidelnikov E, Villamayor S, et al.Identification of Secondary Prevention PatientsEligible for PCSK9 Inhibitors Therapy According to theRoutine Clinical Practice in Spain [published onlineahead of print, 2022 Dec 16]. AdvTher.2022;10.1007/s12325-022-02384-y.doi:10.1007/s12325-022-02384-y
  • 27.Ho PM, Magid DJ, Shetterly SM, et al. Medicationnonadherence is associated with a broad range ofadverse outcomes in patients with coronary arterydisease. Am Heart J. 2008; 155: 772-9.https://doi.org/10.1016/j.ahj.2007.12.011
  • 28.Lin JL, Chen PS, Lin HW, et al. Real-World Analysesof the Safety Outcome among a General PopulationTreated with Statins: An Asian Population-BasedStudy. J Atheroscler Thromb.2022;29(8):1213-25.doi:10.5551/jat.63076
  • 29.Tobert JA, Newman CB. The nocebo effect in thecontext of statin intolerance. J Clin Lipidol.2016;10:739-47. https://doi.org/10.1016/j.jacl.2016.05.002
  • 30.Giugliano RP, Mach F, Zavitz K, et al. Cognitivefunction in a randomized trial of evolocumab. N Engl JMed. 2017;377:633-43.https://doi.org/10.1056/NEJMoa1701131

A Retrospective Study: The Effectiveness of Lipid-Lowering Medications in Individuals at High Risk for Cardiovascular Disease

Yıl 2024, Cilt: 51 Sayı: 1, 10 - 18, 14.03.2024
https://doi.org/10.5798/dicletip.1451412

Öz

Objective: The effective administration of lipid-lowering treatment is of utmost importance in mitigating cardiovascular (CV) risk in patients who are undergoing secondary prevention.
High-dose statins, ezetimibe, and the relatively newer PCSK9 inhibitors (PCSK9i) have shown effectiveness in achieving low density lipoprotein cholesterol(LDL-C) treatment targets for these patients.
However, despite substantial evidence supporting their efficacy, these interventions remain significantly underutilized, primarily due to poor levels of patient adherence.
Moreover, there is limited data available on the overall effectiveness of cholesterol-lowering treatment and the proportion of secondary prevention patients who have achieved a well-regulated lipid profile.
In light of these factors, the principal aim of this investigation was to evaluate the present status of lipid-lowering medication within this specific group of individuals.
Methods: The study was conducted at Mardin Artuklu University, Mardin Training and Research Hospital between April 2021 and March 2023, focusing on patients with a history of secondary prevention of CVD. The study investigated prescribed cholesterol-lowering drugs, factors contributing to statin underuse, and lipid profile disclosure.
Results: 872 patients were included. 86.8% received statins, 5.2% ezetimibe, and 3.4% fibrates, while 13.2% received no lipid-lowering therapy. 64% of those on statins were on high doses. LDL-C values were assessed in 452 patients, with only 30% below the recommended cutoff of 70 mg/dL.
Conclusion: In this investigation involving secondary prevention patients, slightly over half of the participants received high-dose statins, while a negligible proportion received ezetimibe treatment.
Alarmingly, over two-thirds of the patients demonstrated LDL-C values that deviated significantly from the therapeutic range, indicating a considerable gap between their lipid profiles and the recommendations set forth by clinical guidelines.

Kaynakça

  • 1.Presta V, Figliuzzi I, Miceli F, et al. Achievement oflow density lipoprotein (LDL) cholesterol targets inprimary and secondary prevention: Analysis of a largereal practice database in Italy. Atherosclerosis.2019;285:40-8.doi:10.1016/j.atherosclerosis.2019.03.017
  • 2.Behbodikhah J, Ahmed S, Elyasi A, et al.Apolipoprotein B and Cardiovascular Disease:Biomarker and Potential Therapeutic Target.Metabolites. 2021;11(10):690.doi:10.3390/metabo11100690
  • 3.Scott C, Lateef SS, Hong CG, et al. Inflammation,coronary plaque progression, and statin use: Asecondary analysis of the Risk Stratification withImage Guidance of HMG CoA Reductase InhibitorTherapy (RIGHT) study. Clin Cardiol. 2022;45(6):622-8.doi:10.1002/clc.23808
  • 4.Westman EC. A review of decision aids to assesscardiovascular risk. Curr Opin Endocrinol DiabetesObes. 2022;29(5):420-6.doi:10.1097/MED.0000000000000760
  • 5.Sarsam S, Berry A, Degheim G, et al. Real-world useof PCSK9 inhibitors: A single-center experience. J IntMed Res. 2019;47(1):265-70.doi:10.1177/0300060518800595
  • 6.Mach F, Baigent C, Catapano AL, et al. 2019 ESC/EASGuidelines for the management of dyslipidaemias: lipidmodification to reduce cardiovascular risk [publishedcorrection appears in Eur Heart J. 2020 Nov21;41(44):4255]. Eur Heart J. 2020;41(1):111-88.doi:10.1093/eurheartj/ehz455
  • 7.Vallejo-Vaz AJ, Bray S, Villa G, et al. Implications ofACC/AHA Versus ESC/EAS LDL-C Recommendationsfor Residual Risk Reduction in ASCVD: A SimulationStudy From DA VINCI [published online ahead of print, 2022 May 14]. Cardiovasc Drugs Ther.2022;10.1007/s10557-022-07343-x.doi:10.1007/s10557-022-07343-x
  • 8.Klug EQ, Raal FJ. New cholesterol targets for patientsat high or very high cardiovascular risk and theindications for PCSK9 inhibitors. S Afr Med J.2020;110(11):13126.doi:10.7196/SAMJ.2020.v110i11.15191
  • 9.Mc Namara K, Alzubaidi H, Jackson JK.Cardiovascular disease as a leading cause of death:how are pharmacists getting involved? Integr PharmRes Pract. 2019;8:1-11. doi:10.2147/IPRP.S133088
  • 10.Murphy MJ, Grundy EMD. Slowdown in MortalityImprovement in the Past Decade: A US/UKComparison. J Gerontol B Psychol Sci Soc Sci.2022;77(Suppl_2):S138-S147.doi:10.1093/geronb/gbab220
  • 11. Zhang Y, Pletcher MJ, Vittinghoff E, et al. AssociationBetween Cumulative Low-Density LipoproteinCholesterol Exposure During Young Adulthood andMiddle Age and Risk of Cardiovascular Events. JAMA Cardiol. 2021;6(12):1406-13.doi:10.1001/jamacardio.2021.3508
  • 12.Pedersen TR. Randomised trial of cholesterollowering in 4444 patients with coronary heart disease:the Scandinavian Simvastatin Survival Study (4S).Lancet. 1994;344:1383- 9.https://doi.org/10.1016/S0140-6736(94)90566-5
  • 13.Sacks FM, Pfeffer MD, Moye LA, et al. The Effect ofPravastatin on Coronary Events after MyocardialInfarction in Patients with Average Cholesterol Levels.N Engl J Med. 1996;335:1001-9.https://doi.org/10.1056/ NEJM199610033351401
  • 14.Cannon CP, Blazing MA, Giugliano RP, et al.Ezetimibe added to statin therapy after acute coronary syndromes. N Engl J Med. 2015;372:2387-97.https://doi.org/10.1056/ NEJMoa1410489
  • 15.Cholesterol Treatment Trialists’ (CTT)Collaboration. Baigent C, Blackwell L, Emberson J, et al.Efficacy and safety of more intensive lowering of C-LDLcholesterol: a meta-analysis of data from 170 000participants in 26 randomized trials. Lancet. 2010;376: 1670-81.https://doi.org/10.1016/S0140-6736(10)61350-5
  • 16.Cannon CP, Braunwald E, McCabe CH, et al.Intensive versus moderate lipid lowering with statinsafter acute coronary syndromes. N Engl J Med. 2004;350: 1495-504.https://doi.org/10.1056/NEJMoa040583
  • 17.Lee YJ, Cho JY, You SC, et al. Moderate-intensitystatin with ezetimibe vs. high-intensity statin inpatients with diabetes and atheroscleroticcardiovascular disease in the RACING trial. Eur Heart J. 2023;44(11):972-83. doi:10.1093/eurheartj/ehac709
  • 18.Warden BA, Fazio S, Shapiro MD. The PCSK9revolution: Current status, controversies, and futuredirections. Trends Cardiovasc Med. 2020;30(3):179-85.doi:10.1016/j.tcm.2019.05.007
  • 19.Gunta SP, O'Keefe JH, O'Keefe EL, et al. PCSK9inhibitor, ezetimibe, and bempedoic acid: Evidence-based therapies for statin-intolerant patients[published online ahead of print, 2023 Mar 3]. ProgCardiovasc Dis. 2023;S0033-0620(23)00013-0.doi:10.1016/j.pcad.2023.02.007
  • 20.Giugliano RP, Keech A, Murphy SA, et al. ClinicalEfficacy and Safety of Evolocumab in High-RiskPatients Receiving a Statin: Secondary Analysis ofPatients With Low LDL Cholesterol Levels and in Those Already Receiving a Maximal-Potency Statin in aRandomized Clinical Trial. JAMA Cardiol.2017;2(12):1385-91.doi:10.1001/jamacardio.2017.3944
  • 21.Gencer B, Mach F, Guo J, et al. Cognition AfterLowering LDL-Cholesterol With Evolocumab. J Am CollCardiol. 2020;75(18):2283-93.doi:10.1016/j.jacc.2020.03.039
  • 22. Damask A, Steg PG, Schwartz GG, et al. Patients With High Genome-Wide Polygenic Risk Scores for Coronary Artery Disease May Receive Greater Clinical BenefitFrom Alirocumab Treatment in the ODYSSEYOUTCOMES Trial. Circulation. 2020;141(8):624-36. doi:10.1161/CIRCULATIONAHA.119.044434
  • 23.Virani SS, Smith SC Jr, Stone NJ, et al. SecondaryPrevention for Atherosclerotic Cardiovascular Disease:Comparing Recent US and European Guidelines onDyslipidemia. Circulation. 2020;141(14):1121-3.doi:10.1161/CIRCULATIONAHA.119.044282
  • 24.Sabouret P, Lemesle G, Bellemain-Appaix A, et al.Post-discharge and long-term follow-up after an acutecoronary syndrome: International Collaborative Groupof CNCF position paper. Arch Med Sci. 2022;18(4):839-54.doi:10.5114/aoms/150321
  • 25. Pedretti RFE, Hansen D, Ambrosetti M, et al. How to optimize the adherence to a guideline-directed medical therapy in the secondary prevention of cardiovasculardiseases: a clinical consensus statement from theEuropean Association of Preventive Cardiology. Eur JPrev Cardiol. 2023;30(2):149-66.doi:10.1093/eurjpc/zwac204
  • 26.Cosin-Sales J, Sidelnikov E, Villamayor S, et al.Identification of Secondary Prevention PatientsEligible for PCSK9 Inhibitors Therapy According to theRoutine Clinical Practice in Spain [published onlineahead of print, 2022 Dec 16]. AdvTher.2022;10.1007/s12325-022-02384-y.doi:10.1007/s12325-022-02384-y
  • 27.Ho PM, Magid DJ, Shetterly SM, et al. Medicationnonadherence is associated with a broad range ofadverse outcomes in patients with coronary arterydisease. Am Heart J. 2008; 155: 772-9.https://doi.org/10.1016/j.ahj.2007.12.011
  • 28.Lin JL, Chen PS, Lin HW, et al. Real-World Analysesof the Safety Outcome among a General PopulationTreated with Statins: An Asian Population-BasedStudy. J Atheroscler Thromb.2022;29(8):1213-25.doi:10.5551/jat.63076
  • 29.Tobert JA, Newman CB. The nocebo effect in thecontext of statin intolerance. J Clin Lipidol.2016;10:739-47. https://doi.org/10.1016/j.jacl.2016.05.002
  • 30.Giugliano RP, Mach F, Zavitz K, et al. Cognitivefunction in a randomized trial of evolocumab. N Engl JMed. 2017;377:633-43.https://doi.org/10.1056/NEJMoa1701131
Toplam 30 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Tıp Eğitimi
Bölüm Original Articles
Yazarlar

Fethullah Kayan

Serhat Günlü

Yayımlanma Tarihi 14 Mart 2024
Gönderilme Tarihi 16 Ağustos 2023
Yayımlandığı Sayı Yıl 2024 Cilt: 51 Sayı: 1

Kaynak Göster

APA Kayan, F., & Günlü, S. (2024). A Retrospective Study: The Effectiveness of Lipid-Lowering Medications in Individuals at High Risk for Cardiovascular Disease. Dicle Tıp Dergisi, 51(1), 10-18. https://doi.org/10.5798/dicletip.1451412
AMA Kayan F, Günlü S. A Retrospective Study: The Effectiveness of Lipid-Lowering Medications in Individuals at High Risk for Cardiovascular Disease. diclemedj. Mart 2024;51(1):10-18. doi:10.5798/dicletip.1451412
Chicago Kayan, Fethullah, ve Serhat Günlü. “A Retrospective Study: The Effectiveness of Lipid-Lowering Medications in Individuals at High Risk for Cardiovascular Disease”. Dicle Tıp Dergisi 51, sy. 1 (Mart 2024): 10-18. https://doi.org/10.5798/dicletip.1451412.
EndNote Kayan F, Günlü S (01 Mart 2024) A Retrospective Study: The Effectiveness of Lipid-Lowering Medications in Individuals at High Risk for Cardiovascular Disease. Dicle Tıp Dergisi 51 1 10–18.
IEEE F. Kayan ve S. Günlü, “A Retrospective Study: The Effectiveness of Lipid-Lowering Medications in Individuals at High Risk for Cardiovascular Disease”, diclemedj, c. 51, sy. 1, ss. 10–18, 2024, doi: 10.5798/dicletip.1451412.
ISNAD Kayan, Fethullah - Günlü, Serhat. “A Retrospective Study: The Effectiveness of Lipid-Lowering Medications in Individuals at High Risk for Cardiovascular Disease”. Dicle Tıp Dergisi 51/1 (Mart 2024), 10-18. https://doi.org/10.5798/dicletip.1451412.
JAMA Kayan F, Günlü S. A Retrospective Study: The Effectiveness of Lipid-Lowering Medications in Individuals at High Risk for Cardiovascular Disease. diclemedj. 2024;51:10–18.
MLA Kayan, Fethullah ve Serhat Günlü. “A Retrospective Study: The Effectiveness of Lipid-Lowering Medications in Individuals at High Risk for Cardiovascular Disease”. Dicle Tıp Dergisi, c. 51, sy. 1, 2024, ss. 10-18, doi:10.5798/dicletip.1451412.
Vancouver Kayan F, Günlü S. A Retrospective Study: The Effectiveness of Lipid-Lowering Medications in Individuals at High Risk for Cardiovascular Disease. diclemedj. 2024;51(1):10-8.