Cargando…
The Impact of the 2019 European Guideline for Cardiovascular Risk Management: A Cross-Sectional Study in General Practice
The aim of this study was to assess the impact of the 2019 published European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guideline on cardiovascular (CV) risk management compared with its predecessor from 2016 in a cohort in general practice. We performed a cross-sectional re...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7408902/ https://www.ncbi.nlm.nih.gov/pubmed/32645925 http://dx.doi.org/10.3390/jcm9072140 |
_version_ | 1783567939807477760 |
---|---|
author | Meier, Rahel Rachamin, Yael Rosemann, Thomas Markun, Stefan |
author_facet | Meier, Rahel Rachamin, Yael Rosemann, Thomas Markun, Stefan |
author_sort | Meier, Rahel |
collection | PubMed |
description | The aim of this study was to assess the impact of the 2019 published European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guideline on cardiovascular (CV) risk management compared with its predecessor from 2016 in a cohort in general practice. We performed a cross-sectional retrospective study with data from electronic medical records. The study cohort included 103,351 patients with known CV risk. We assessed changes in CV risk classification and low-density lipoprotein cholesterol (LDL-C) target values, the impact on LDL-C achievement rates, and the current lipid-lowering treatments. Under the 2019 ESC guideline, CV risk categories changed in 27.5% of patients, LDL-C target levels decreased in 71.4% of patients, and LDL-C target achievement rate dropped from 31.1% to 16.5%. Among non-achievers according to the 2019 guideline, 52.2% lacked lipid-lowering drugs entirely, and 41.5% had conventional drugs at a submaximal intensity. Of patients in the high-risk and very high-risk categories, at least 5% failed to achieve the LDL-C target level despite treatment at maximal intensity with conventional lipid-lowering drugs, making them eligible for PCSK-9 inhibitors. In conclusion, the 2019 ESC/EAS guideline lowered LDL-C target values for the majority of patients in general practice and halved LDL-C target achievement rates. There is still a large undeveloped potential to lower CV risk by introducing conventional lipid-lowering drugs, particularly in patients at high or very high CV risk. A substantial proportion of the patients can only achieve their LDL-C targets using PCSK-9 inhibitors, which would currently require an at least 10-fold increase in prescribing of these drugs. |
format | Online Article Text |
id | pubmed-7408902 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-74089022020-08-13 The Impact of the 2019 European Guideline for Cardiovascular Risk Management: A Cross-Sectional Study in General Practice Meier, Rahel Rachamin, Yael Rosemann, Thomas Markun, Stefan J Clin Med Article The aim of this study was to assess the impact of the 2019 published European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guideline on cardiovascular (CV) risk management compared with its predecessor from 2016 in a cohort in general practice. We performed a cross-sectional retrospective study with data from electronic medical records. The study cohort included 103,351 patients with known CV risk. We assessed changes in CV risk classification and low-density lipoprotein cholesterol (LDL-C) target values, the impact on LDL-C achievement rates, and the current lipid-lowering treatments. Under the 2019 ESC guideline, CV risk categories changed in 27.5% of patients, LDL-C target levels decreased in 71.4% of patients, and LDL-C target achievement rate dropped from 31.1% to 16.5%. Among non-achievers according to the 2019 guideline, 52.2% lacked lipid-lowering drugs entirely, and 41.5% had conventional drugs at a submaximal intensity. Of patients in the high-risk and very high-risk categories, at least 5% failed to achieve the LDL-C target level despite treatment at maximal intensity with conventional lipid-lowering drugs, making them eligible for PCSK-9 inhibitors. In conclusion, the 2019 ESC/EAS guideline lowered LDL-C target values for the majority of patients in general practice and halved LDL-C target achievement rates. There is still a large undeveloped potential to lower CV risk by introducing conventional lipid-lowering drugs, particularly in patients at high or very high CV risk. A substantial proportion of the patients can only achieve their LDL-C targets using PCSK-9 inhibitors, which would currently require an at least 10-fold increase in prescribing of these drugs. MDPI 2020-07-07 /pmc/articles/PMC7408902/ /pubmed/32645925 http://dx.doi.org/10.3390/jcm9072140 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Meier, Rahel Rachamin, Yael Rosemann, Thomas Markun, Stefan The Impact of the 2019 European Guideline for Cardiovascular Risk Management: A Cross-Sectional Study in General Practice |
title | The Impact of the 2019 European Guideline for Cardiovascular Risk Management: A Cross-Sectional Study in General Practice |
title_full | The Impact of the 2019 European Guideline for Cardiovascular Risk Management: A Cross-Sectional Study in General Practice |
title_fullStr | The Impact of the 2019 European Guideline for Cardiovascular Risk Management: A Cross-Sectional Study in General Practice |
title_full_unstemmed | The Impact of the 2019 European Guideline for Cardiovascular Risk Management: A Cross-Sectional Study in General Practice |
title_short | The Impact of the 2019 European Guideline for Cardiovascular Risk Management: A Cross-Sectional Study in General Practice |
title_sort | impact of the 2019 european guideline for cardiovascular risk management: a cross-sectional study in general practice |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7408902/ https://www.ncbi.nlm.nih.gov/pubmed/32645925 http://dx.doi.org/10.3390/jcm9072140 |
work_keys_str_mv | AT meierrahel theimpactofthe2019europeanguidelineforcardiovascularriskmanagementacrosssectionalstudyingeneralpractice AT rachaminyael theimpactofthe2019europeanguidelineforcardiovascularriskmanagementacrosssectionalstudyingeneralpractice AT rosemannthomas theimpactofthe2019europeanguidelineforcardiovascularriskmanagementacrosssectionalstudyingeneralpractice AT markunstefan theimpactofthe2019europeanguidelineforcardiovascularriskmanagementacrosssectionalstudyingeneralpractice AT meierrahel impactofthe2019europeanguidelineforcardiovascularriskmanagementacrosssectionalstudyingeneralpractice AT rachaminyael impactofthe2019europeanguidelineforcardiovascularriskmanagementacrosssectionalstudyingeneralpractice AT rosemannthomas impactofthe2019europeanguidelineforcardiovascularriskmanagementacrosssectionalstudyingeneralpractice AT markunstefan impactofthe2019europeanguidelineforcardiovascularriskmanagementacrosssectionalstudyingeneralpractice |