Preview

Rational Pharmacotherapy in Cardiology

Advanced search

TREATMENT OF PATIENTS WITH SEVERE DYSLIPIDEMIA IN REAL CLINICAL PRACTICE

https://doi.org/10.20996/1819-6446-2015-11-4-380-384

Full Text:

Abstract

Cardiovascular diseases remain the most common cause of death in Russia. In real clinical practice doctors are more focused on the modification of other major risk factors rather than on the correction of dyslipidemia, or pay more attention to secondary prevention of cardiovascular diseases.

Aim. To analyze the incidence of severe dyslipidemia (total cholesterol >9 mmol/l), clinical signs of atherosclerosis at its presence and the adequacy of hypolipidemic treatment according to the data of multi-field medical hospital.

Material and methods. We have analyzed 28225 medical charts of patients undergoing treatment in Therapeutic Departments of Petrozavodsk urgent care hospital for the years from 2001 to 2012.

Results. The incidence of severe dyslipidemia (total cholesterol >9 mmol/l) was 1.59%. The most frequent nonlipid risk factor for ischemic heart disease was arterial hypertension (was diagnosed in 85% of patients). The main clinical manifestation of atherosclerosis was ischemic heart disease (it was diagnosed in 79.3%), 48.9% of patients had a history of acute myocardial infarction, 28.9% - of stroke. In patients with severe dyslipidemia (total cholesterol >9 mmol/l) the frequency of statins prescription in 2009-2012 was 70%. In 28.9% of the patients the target levels of total cholesterol and low-density lipoprotein were obtained. High doses of statins were prescribed rarely.

Conclusion. There is a serious therapeutic problem related to the insufficient attention of doctors to examination and treatment of patients with newly-diagnosed severe dyslipidemia, especially when the primary disease is not a cardiovascular one.

About the Authors

V. A. Korneva
Petrozavodsk State University
Russian Federation
Lenina prospekt 33, Petrozavodsk, 185001 Russia


T. Yu. Kuznetsova
Petrozavodsk State University
Russian Federation
Lenina prospekt 33, Petrozavodsk, 185001 Russia


E. S. Karpova
Petrozavodsk State University
Russian Federation
Lenina prospekt 33, Petrozavodsk, 185001 Russia


K. I. Rupasova
Petrozavodsk State University
Russian Federation
Lenina prospekt 33, Petrozavodsk, 185001 Russia


References

1. Kuharchuk V.V. Atherosclerosis: disputable and unsolved problems in the first decade of the XXI century. Ter arkhiv 2009; 5: 14-20. Russian (Кухарчук В.В. Спорные и нерешенные вопросы в проблеме атеросклероза в первой декаде XXI века Терапевтический архив 2009; 5: 14-20).

2. Yusyf S. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study). Lancet 2004; 364: 937-52.

3. Cholesterol Treatment Trialists' (СЕЕ) Collaborators. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170000 participants in 26 randomized trials. Lancet 2010; 376:1670-81.

4. Oganov R.G., Kuharchuk V.V., Arutjunov G.P. et al. Persistent dyslipidemia in statin-treated patients: Russian real-world clinical practice data (Russian part of the DYSIS Study). Kardiovaskuljarnaja Terapija I Profilaktika 2012; 11(4):70-8. Russian. (Оганов Р.Г., Кухарчук В.В., Арутюнов Г.П. и др. Сохраняющиеся нарушения показателей липидного спектра у пациентов с дислипидемией, получающих статины, в реальной клинической практике в Российской Федерации (Российская часть исследования DYSIS). Кардиоваскулярная терапия и профилактика 2012; 11(4):70-8).

5. Susekov A.V. Gornjakova, N.B, Zubareva M.Yu. et al. Double cholesterol inhibition — a new approach to effective control of hyperlipidemia and atherosclerosis Kardiovaskuljarnaja Terapija I Profilaktika 2009; 6: 98-110. Russian (Сусеков А.В. Двойное ингибирование холестерина – новый подход к эффективному контролю гиперлипидемии и атеросклероза. Кардиоваскулярная терапия и профилактика 2009; 6: 98-110).

6. Konstantinov V.O. News in the prevention of atherosclerosis and its complications. Spravochnik Poliklinicheskogo Vracha 2012; 2:7-12. Russian (Константинов В.О. Новое в профилактике атеросклероза и его осложнений. Справочник поликлинического врача 2012; 2: 7-12).

7. Diagnosis and correction of lipid metabolism disorders for prevention and treatment of atherosclerosis. Russian guidelines; 5th revision; 2012. Available at: http://www.scardio.ru/content/Guidelines/rek_lipid_2012.pdf. Accessed by 15.08.2015. Russian. (Диагностика и коррекция нарушений липидного обмена с целью профилактики и лечения атеросклероза. Российские рекомендации, 5 пересмотр; 2012. Доступно на: http://www.scardio.ru/content/Guidelines/rek_lipid_2012.pdf. Проверено 15.08.2015).

8. Reiner Z., Catapano A.L., Guy De Backer et al. ESC/EAS Guidelines for the management of dyslipidaemias .European Heart Journal 2011; 32:1769-818

9. Barter PJ., Puranik R, Rye KA. New insights into the role of HDL as an anti-inflammatory agent in the prevention of cardiovascular disease. Curr Cardiol Rep 2007;9: 493-8.

10. Marcevich S.Yu., Gajsenok S.G., Tripkosh S.G. et al. Real practice of statins use and its dependence on follow-up in the specialized medical centre in patients with high cardiovascular risk (according the PROFILE register). Ration Pharmacoter Cardiol 2013; 9(4): 362-7. Russian (Марцевич С.Ю., Гайсенок С.Г., Трипкош С.Г. и др. Реальная практика назначения статинов и ее зависимость от наблюдения в специализированном медицинском центре у больных с высоким риском сердечно-сосудистых осложнений (по данным регистра ПРОФИЛЬ). Рациональная Фармакотерапия в Кардиологии 2013; 9 (4): 362-7).

11. Ershova A.I., Meshkov A.N., Jakushin S.S. et al. Diagnosis and treatment of patients with severe hypercholesterolemia in real outpatient practice (according to RECVASA registry). Ration Pharmacoter Cardiol 2014; 10(6):612-616. Russian (Ершова А.И., Мешков А.Н., Якушин С.С. и др. Диагностика и лечение больных с выраженной гиперхолестеринемией в реальной амбулаторно-поликлинической практике (по данным регистра РЕКВАЗА). Рациональная фармакотерапия в кардиологии 2014; 10(6):612-6).

12. Fourth Joint Task Force of European Society of Cardiology and other Societies on Cardiovascular disease Prevention in Clinical Practice. European guidelines on cardiovascular disease prevention in clinical practice: executive summary. Eur Heart J 2007; 28: 2375-414.

13. Konstantinov V.O. Potential and methods of target cholesterol level achievement in daily clinical practice: results of the Russian multi-centre observation study «TREAT TO GOAL». Kardiovaskuljarnaja Terapija I Profilaktika 2011; 10(2):110-5. Russian (Константинов В.О. Возможности и пути достижения целевых уровней холестерина в условиях повседневной клинической практики (результаты российского, многоцентрового наблюдательного исследования «TREAT TO GOAL». Кардиоваскулярная терапия и профилактика 2011; 10(2):110-5.

14. Deev A.D., Kuharchuk V.V., Rozhkova T.A. et al. The main results of the Moscow research on statins (Moscow Statin Survey, MSS). Serdce 2006;6:324-8. Russian. (Деев А.Д., Кухарчук В.В., Рожкова Т.А. и др. Основные результаты Московского исследования по статинам (Moscow Statin Survey, MSS). Сердце 2006; 6: 324-8.

15. Foley KA. Effectiveness of statin titration on low density lipoprotein cholesterol goal attainment in patients at high risk of atherogenic events. Am J Cardiol 2003; 92: 78-81.

16. Phatak H. Prevalence and predictors of lipid abnormalities in patients treated with statins in the UK general practice. Atherosclerosis 2009;202: 225-33.

17. Kotsleva K., Wood D., De Backer G. et al. (EUROASPIRE STUDY GROUP). Cardiovascular prevention guidelines in daily practice: a comparison of EUROASPIRE I,II and III surveys in eight European countries. Lancet 2009; 373:929-40.


For citation:


Korneva V.A., Kuznetsova T.Y., Karpova E.S., Rupasova K.I. TREATMENT OF PATIENTS WITH SEVERE DYSLIPIDEMIA IN REAL CLINICAL PRACTICE. Rational Pharmacotherapy in Cardiology. 2015;11(4):380-384. (In Russ.) https://doi.org/10.20996/1819-6446-2015-11-4-380-384

Views: 422


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)