Original scientific paper

https://doi.org/10.20471/acc.2020.59.04.10

Management of Hyperlipidemia in Very High and Extreme Risk Patients in Croatia: an Observational Study of Treatment Patterns and Lipid Control

Hrvoje Pintarić orcid.org/0000-0003-0072-3543 ; University of Zagreb, School of Dental Medicine, Zagreb, Croatia; Sestre milosrdnice University Hospital Centre, Department of Internal Medicine, Zagreb, Croatia
Marijana Knezović Florijan ; Sestre milosrdnice University Hospital Centre, Department of Internal Medicine, Zagreb, Croatia
Ian Bridges ; Amgen Ltd., Cambridge, United Kingdom
Robert Steiner ; Osijek University Hospital Centre, Department of Cardiology, Osijek, Croatia
Luka Zaputović ; Rijeka University Hospital Centre, Rijeka, Croatia
Davor Miličić ; University of Zagreb, School of Medicine, Department of Cardiovascular Diseases, Zagreb University Hospital Centre, Zagreb, Croatia

Abstract

Our observational study evaluated current management of elevated low-density
lipoprotein cholesterol (LDL -C) in adult secondary prevention patients (all very high risk (VHR) by
European guidelines) attending specialist clinics across Croatia. Data were collected retrospectively
from patient records for the preceding 12 months. The subset judged to be at extreme risk (ER ;
American Association of Clinical Endocrinologists (AACE) criteria; n=48) were compared with the
remaining patients (VHR group; n=41). All patients were receiving statins (75.6% VHR/81.3% ER at
high-intensity), with only a minority receiving concomitant lipid-lowering treatment (7.3%
VHR/16.7% ER ). Median (Q1, Q3) LDL -C levels at the last visit were 1.9 (1.6, 2.4) mmol/L for
VHR and 2.1 (1.5, 3.1) mmol/L for ER , with only 41.5% (95% CI 26.3-57.9) of VHR patients and
27.1% (15.3-41.9) of ER patients attaining their LDL -C targets (<1.8 mmol/L and <1.42 mmol/L,
respectively). Thus, we found that a substantial proportion of VHR and ER secondary prevention
patients being treated across Croatia had LDL -C levels exceeding the targets recommended in the
European and newer AACE guidelines, but not all were receiving high-intensity statins. Identification
of ER patients and their lipid patterns may help optimize usage of high-intensity statin treatment,
alone or along with newer treatments, for better control of elevated LDL -C.

Keywords

Hyperlipidemia; Secondary prevention; High-risk patients; Very high-risk patients; Extreme risk patients

Hrčak ID:

253754

URI

https://hrcak.srce.hr/253754

Publication date:

1.12.2020.

Article data in other languages: croatian

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