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LIPID-LOWERING THERAPY IN OUTPATIENT PRACTICE (ACCORDING TO THE ARGO-2 STUDY)

https://doi.org/10.20996/1819-6446-2016-12-2-147-153

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Abstract

Aim. To study the features of lipid-lowering therapy with rosuvastatin in high and very high cardiovascular risk patients in real outpatient practice.
Material and methods. Patients ≥30 years, visited internists or cardiologists of district outpatient clinics in the period from October 2013 to July 2014 were included into the study. Each patient fill in questionnaire. Determination of total cholesterol (TC) level was performed without special preparation of the patient using a portable photometric blood analyzer. Doctors prescribed rosuvastatin therapy when indicated, in accordance with the Guidelines, choosing the dose on their own. Repeated TC level was determined after 1 month.
Results. TC level was initially determined in 10547 patients. Rosuvastatin treatment was recommended for all patients. Repeated TC level determination was performed in 7897 patients in an average after 33 days. Baseline TC level in them was 6.37±0.89 mmol/l, and after 1 month while taking rosuvastatin – 4.89±0.81 mmol/l (p<0.001). The change of TC level was -22% (p<0.001). The average prescribed dose of rosuvastatin was 11.88±5.1 mg per day. The most often (62.8%) rosuvastatin was prescribed in a dose of 10 mg per day, in 27.3% of patients – 20 mg per day, in 9.2% – 5 mg per day, and only 0.5% of patients took it in the maximal dose.
Conclusion. In real clinical practice, rosuvastatin for treatment of patients with high or very high cardiovascular risk is often prescribed in moderate doses and rarely in the maximum dose despite the proven lipid-lowering effect.

About the Authors

N. M. Akhmedzhanov
State Research Centre for Preventive Medicine, Moscow
Russian Federation


D. V. Nebieridze
State Research Centre for Preventive Medicine, Moscow
Russian Federation


A. S. Safaryan
State Research Centre for Preventive Medicine, Moscow
Russian Federation


V. A. Vygodin
State Research Centre for Preventive Medicine, Moscow
Russian Federation


A. Yu. Shuraev
EGIS Pharmaceuticals, Representation in Russia, Moscow
Russian Federation


A. N. Tkacheva
State Research Centre for Preventive Medicine, Moscow
Russian Federation


A. S. Lishuta
I.M. Sechenov First Moscow State Medical University, Moscow
Russian Federation


References

1. Diagnostics and correction of lipid disorders for the prevention and treatment of atherosclerosis. Russian recommendations. 5 review. Available at: http://www.scardio.ru/content/Guidelines/ rek_lipid_2012.pdf. Accessed by 18/04/2016. Russian (Диагностика и коррекция нарушений липидного обмена с целью профилактики и лечения атеросклероза. Российские Рекомендации. 5 пересмотр. Доступно на: http://www.scardio.ru/content/Guidelines/rek_lipid_2012.pdf. Проверено 18.04.2016)

2. ESC/EAS Guidelines for the management of dyslipidaemias. Eur Heart J 2011; 32: 1769-818

3. Muromtseva G.A., Kontsevaya A.V., Konstantinov V.V. et al. Prevalence of risk factors for noncommunicable diseases in the Russian population in 2012-2013. The study ESSE-RF. Kardiovaskulyarnaya Terapiya i Profilaktika 2014; 6: 4-11. Russian (Муромцева Г.А., Концевая А.В., Константинов В.В. и др. Распространенность факторов риска неинфекционных заболеваний в российской популяции в 2012-2013 гг. Результаты исследования ЭССЕ-РФ. Кардиоваскулярная Терапия и Профилактика 2014; 6: 4-11)

4. Ershova AI, Meshkov AN, Yakushin SS, et al. Diagnosis and treatment of patients with severe hypercholesterolemia in real outpatient practice (according to the register REKVAZA). Ration Pharmacother Cardiol 2014; 10 (6): 612-6. Russian (Ершова А.И., Мешков А.Н., Якушин С.С. и др. Диагностика и лечение больных с выраженной гиперхолестеринемией в реальной амбулаторнополиклинической практике (по данным регистра РЕКВАЗА). Рациональная Фармакотерапия в Кардиологии 2014;10(6):612-6)

5. Accutrend Plus user manual. Roche Diagnostics; 2014.

6. Akhmedzhanov N.M., Nebieridze D.V., Safaryan A.S., Vygodin V.A., Shuraev A.Y., Tkacheva O.N., Lishuta A.S. Analysis of hypercholesterolemia prevalence in the outpatient practice (according to the ARGO study): PART I. Rational Pharmacotherapy in Cardiology 2015;11(3):253-260. Ахмеджанов Н.М., Небиеридзе Д.В., Сафарян А.С., Выгодин В.А., Шураев А.Ю., Ткачева О.Н., Лишута А.С. Анализ распространенности гиперхолестеринемии в условиях амбулаторной практики (по данным исследования АРГО): ЧАСТЬ I. Рациональная Фармакотерапия в Кардиологии . 2015;11(3):253-260.

7. Goff DC Jr, Bertoni AG, Kramer H et al. Dyslipidemia prevalence, treatment, and control in the MultiEthnic Study of Atherosclerosis (MESA): gender, ethnicity, and coronary artery calcium. Circulation 2006;113(5):647-56.

8. Sun GZ, Li Z, Guo L, Zhou Y, et al. High prevalence of dyslipidemia and associated risk factors among rural Chinese adults. Lipids Health Dis 2014;13:189

9. Viigimaa M, Erglis A, Latkovskis G, et al. Prevalence of dyslipidemia in statin-treated patients in the Baltic states (Estonia, Latvia, and Lithuania): results of the Dyslipidemia International Study (DYSIS). Medicina (Kaunas) 2014;50(1):44-53

10. Zhao S, Wang Y, Mu Y et al. Prevalence of dyslipidaemia in patients treated with lipid-lowering agents in China: results of the DYSlipidemia International Study (DYSIS). Atherosclerosis 2014;235(2): 463-9

11. Kovsh E.V., Bulgak A.G., Bel'skaya M.I. et al. Therapeutic Equivalence Rozulip drug in comparison with the original rosuvastatin in patients with hypercholesterolemia. Russkiy Meditsinskiy Zhurnal 2013;

12. : 1301-5. In Russian (Ковш Е.В., Булгак А.Г., Бельская М.И. и др. Терапевтическая эквивалентность препарата Розулип в сравнении с оригинальным розувастатином у пациентов с гиперхолестеринемией. Русский Медицинский Журнал 2013; 27: 1301-5).

13. Stalenhoef AF, Ballantyne CM, Sarti C, et al. A comparative study with rosuvastatin in subjects with metabolic syndrome: results of the COMETS study. Eur Heart J 2005;26(24):2664-72.

14. Pitt B, Loscalzo J, Monyak J, et al. Comparison of lipid-modifying efficacy of rosuvastatin versus atorvastatin in patients with acute coronary syndrome (from the LUNAR study). Am J Cardiol 2012;109(9):1239-46.

15. Stender S, Schuster H, Barter P, et al. Comparison of rosuvastatin with atorvastatin, simvastatin and pravastatin in achieving cholesterol goals and improving plasma lipids in hypercholesterolaemic patients with or without the metabolic syndrome in the MERCURY I trial. Diabetes Obes Metab 2005;7(4):430-8.

16. Insull W Jr1, Ghali JK, Hassman DR, et al. Achieving low-density lipoprotein cholesterol goals in highrisk patients in managed care: comparison of rosuvastatin, atorvastatin, and simvastatin in the SOLAR trial. Mayo Clin Proc. 2007 May;82(5):543-50.

17. Jones PH, Davidson MH, Stein EA, et al. Comparison of the efficacy and safety of rosuvastatin versus atorvastatin, simvastatin, and pravastatin across doses (STELLAR* Trial). Am J Cardiol 2003;92(2): 152-60.

18. Furie KL. High-dose statins should only be used in atherosclerotic strokes. Stroke. 2012 Jul;43(7): 1994-5.

19. Sardella G, Lucisano L. High dose statins should be used in all patients undergoing percutaneous coronary intervention. Int J Cardiol. 2014;172(1):e139.

20. Talavera J.O., Martinez G., Cervantes J.L. et al. A Double Blind, Double Dummy, Randomized, Placebo Control Trial to Evaluate the Effect of Statin Therapy on Triglycerides Levels in Mexican Hypertriglyceridemic Patients. Curr Med Res Opin 2013; 29(4): 379-86.

21. Ballantyne CM, Raichlen JS, Nicholls SJ, et al. Effect of rosuvastatin therapy on coronary artery stenoses assessed by quantitative coronary angiography: a study to evaluate the effect of rosuvastatin on intravascular ultrasound-derived coronary atheroma burden. Circulation 2008;117(19):2458-66.


For citation:


Akhmedzhanov N.M., Nebieridze D.V., Safaryan A.S., Vygodin V.A., Shuraev A.Y., Tkacheva A.N., Lishuta A.S. LIPID-LOWERING THERAPY IN OUTPATIENT PRACTICE (ACCORDING TO THE ARGO-2 STUDY). Rational Pharmacotherapy in Cardiology. 2016;12(2):147-153. (In Russ.) https://doi.org/10.20996/1819-6446-2016-12-2-147-153

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ISSN 1819-6446 (Print)
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