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EU-Wi<i>d</i>e Cross-Section<i>a</i>l Obser<i>v</i>at<i>i</i>o<i>n</i>al Study of Lipid-Modifying Therapy Use in Se<i>c</i>ondary and Pr<i>i</i>mary Care: the DA VINCI study

Kausik K. RayImperial Centre for Cardiovascular Disease Prevention and Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UKBart MolemansAmgen Inc., 1 Amgen Center Drive, Thousand Oaks, CA 91320, USAW. Marieke SchoonenCenter for Observational Research (CfOR), Amgen Ltd, 1 Uxbridge Business Park Sanderson Road, Uxbridge, UB8 1DH, UKPeriklis GiovasSarah BrayGlobal Biostatistical Science, Amgen Ltd, 240 Cambridge Science Park, Milton Road, Cambridge, CB4 0WD, UKGaia KiruImperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UKJennifer MurphyImperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UKMaciej BanachCardiovascular Research Centre, University of Zielona Góra, 65-417 Zielona Góra, PolandStefano De ServiIRCCS MultiMedica, Via Milanese, 300, 20099 Sesto San Giovanni, Milan, ItalyDan GaițăInstitutul de Boli Cardiovasculare, Fundatia Cardioprevent, Universitatea de Medicina si Farmacie Victor Babes din Timisoara, Timişoara 300041, RomaniaIoanna Gouni‐BertholdG. Kees HovinghUniversity of Amsterdam Faculty of Medicine, Amsterdam, the NetherlandsJacek Jerzy JozwiakDepartment of Family Medicine and Public Health, Faculty of Medicine, University of Opole, Opole, PolandJ. Wouter JukemaLeiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, NetherlandsRóbert Gábor KissSerge KownatorHelle K. IversenFaculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, DenmarkVincent MaherAdvanced Lipid Management and Research Centre, Tallaght University Hospital, Dublin 24, IrelandL. MasanaUniversitat Rovira i Virgili, IISPV, CIBERDEM, Saint Joan University Hospital, Reus, SpainAlexander ParkhomenkoAndré PeetersCliniques Universitaires Saint Luc, Avenue Hippocrate 10, 1200, Brussels, BelgiumPiers CliffordImperial Hospitals NHS Trust (Hammersmith Campus), London W12 0HS, UKKatarı́na RašlováSlovak Medical University, 831 01 Bratislava, SlovakiaPeter SiostrzonekKrankenhaus Barmherzige Schwestern Linz, Seilerstðtte 4, 4010 Seilerstätte 4, 4010 Linz, AustriaStefano RomeoCardiology Department, Sahlgrenska University Hospital, 413 45 Gothenburg, SwedenDimitrios TousoulisNational and Kapodistrian University of Athens, Medical School, Athens, GreeceCharalambos VlachopoulosNational and Kapodistrian University of Athens, Medical School, Athens, GreeceMichal Vrablı́kCharles University, Prague, 116 36 Czech RepublicAlberico L. CatapanoDepartment of Pharmacological and Biomolecular Sciences, IRCCS Multimedica, Via Milanese, 300, 20099 Sesto San Giovanni, Milan, ItalyNeil R PoulterImperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UKthe DA VINCI study
2020en
ABI

Аннотация

AIMS: To provide contemporary data on the implementation of European guideline recommendations for lipid-lowering therapies (LLTs) across different settings and populations and how this impacts low-density lipoprotein cholesterol (LDL-C) goal achievement. METHODS AND RESULTS: An 18 country, cross-sectional, observational study of patients prescribed LLT for primary or secondary prevention in primary or secondary care across Europe. Between June 2017 and November 2018, data were collected at a single visit, including LLT in the preceding 12 months and most recent LDL-C. Primary outcome was the achievement of risk-based 2016 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) LDL-C goal while receiving stabilized LLT; 2019 goal achievement was also assessed. Overall, 5888 patients (3000 primary and 2888 secondary prevention patients) were enrolled; 54% [95% confidence interval (CI) 52-56] achieved their risk-based 2016 goal and 33% (95% CI 32-35) achieved their risk-based 2019 goal. High-intensity statin monotherapy was used in 20% and 38% of very high-risk primary and secondary prevention patients, respectively. Corresponding 2016 goal attainment was 22% and 45% (17% and 22% for 2019 goals) for very high-risk primary and secondary prevention patients, respectively. Use of moderate-high-intensity statins in combination with ezetimibe (9%), or any LLT with PCSK9 inhibitors (1%), was low; corresponding 2016 and 2019 goal attainment was 53% and 20% (ezetimibe combination), and 67% and 58% (PCSK9i combination). CONCLUSION: Gaps between clinical guidelines and clinical practice for lipid management across Europe persist, which will be exacerbated by the 2019 guidelines. Even with optimized statins, greater utilization of non-statin LLT is likely needed to reduce these gaps for patients at highest risk.

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Идентификаторы

DOI
10.1093/eurjpc/zwaa047

Цитирования и источники

Цитирований: 2Использованных источников: 0
Показатели — AkademScholar