The characteristics of two LDL-cholesterol level reduction treatment strategies, 'treat-to-target' and 'percent reduction': an observational study without intervention

Autor: Albert Császár
Rok vydání: 2018
Předmět:
Male
medicine.medical_specialty
lcsh:Diseases of the circulatory (Cardiovascular) system
Time Factors
Clinical Decision-Making
Hypercholesterolemia
Down-Regulation
030204 cardiovascular system & hematology
Risk Assessment
2014 ACC/AHA guideline
Reduction (complexity)
03 medical and health sciences
0302 clinical medicine
Risk groups
Risk Factors
Internal medicine
Medicine
Humans
030212 general & internal medicine
Angiology
Ldl cholesterol
Reduction strategy
business.industry
Treat to target
Cholesterol
LDL
Middle Aged
Statin therapy
Percent LDL-cholesterol reduction
Treatment Outcome
lcsh:RC666-701
Cardiovascular Diseases
Observational study
lipids (amino acids
peptides
and proteins)
Female
Reduction treatment
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Cardiology and Cardiovascular Medicine
business
Biomarkers
Research Article
Zdroj: BMC Cardiovascular Disorders
BMC Cardiovascular Disorders, Vol 19, Iss 1, Pp 1-6 (2019)
ISSN: 1471-2261
Popis: Background The 2014 ACC/AHA guidelines redefined the strategy for LDL-cholesterol (LDL-C) treatment. According to data from evidence-based studies, the basis for earlier therapeutic recommendations for LDL-C target levels (2.6 and 1.8 mmol/L) may be disputed, and only the data for the percent LDL-C reduction are objective. The target is a moderate intensity (30–50%) LDL-C reduction in the high cardiovascular (CV) risk group, and a high intensity LDL-C reduction (> 50%) in the very high risk group. In our study, we analysed the success of the two types of strategies in attaining the target in the everyday routine. Methods Of 5652 patients suffering from hypercholesterolemia, 4302 underwent treat-to-target treatment, and 1350 patients were treated with a percent reduction strategy. Physicians were free to choose the dosage and the target treatment form. The 12-month study included three follow-up visits. Results In the high CV risk, statin-naive subgroup the percent LDL-C reduction strategy has been proven to be clearly more successful than the treat-to-target strategy, i.e. a higher proportion of patients reached the target values. We observed that the absolute value corresponding to a percent reduction target is higher if the baseline LDL-C is higher, and therefore it is easier to reach. Conclusion Therefore, in this large subgroup of patients with baseline LDL-C level higher than 3.9 mmol/L may be recommended the adaptation of the percent reduction assessment.
Databáze: OpenAIRE
Externí odkaz: