Articles producció científica> Medicina i Cirurgia

EU-Wide Cross-Sectional Observational Study of Lipid-Modifying Therapy Use in Secondary and Primary Care: the DA VINCI study

  • Identification data

    Identifier: imarina:9229984
    Authors:
    Ray, Kausik K.Molemans, BartSchoonen, W. MariekeGiovas, PeriklisBray, SarahKiru, GaiaMurphy, JenniferBanach, MaciejDe Servi, StefanoGaita, DanGouni-Berthold, IoannaHovingh, G. KeesJozwiak, Jacek J.Jukema, J. WouterKiss, Robert GaborKownator, SergeIversen, Helle K.Maher, VincentMasana, LuisParkhomenko, AlexanderPeeters, AndreClifford, PiersRaslova, KatarinaSiostrzonek, PeterRomeo, StefanoTousoulis, DimitriosVlachopoulos, CharalambosVrablik, MichalCatapano, Alberico L.Poulter, Neil R.DA VINCI study
    Abstract:
    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 re
  • Others:

    Author, as appears in the article.: Ray, Kausik K.; Molemans, Bart; Schoonen, W. Marieke; Giovas, Periklis; Bray, Sarah; Kiru, Gaia; Murphy, Jennifer; Banach, Maciej; De Servi, Stefano; Gaita, Dan; Gouni-Berthold, Ioanna; Hovingh, G. Kees; Jozwiak, Jacek J.; Jukema, J. Wouter; Kiss, Robert Gabor; Kownator, Serge; Iversen, Helle K.; Maher, Vincent; Masana, Luis; Parkhomenko, Alexander; Peeters, Andre; Clifford, Piers; Raslova, Katarina; Siostrzonek, Peter; Romeo, Stefano; Tousoulis, Dimitrios; Vlachopoulos, Charalambos; Vrablik, Michal; Catapano, Alberico L.; Poulter, Neil R.;DA VINCI study
    Department: Medicina i Cirurgia
    URV's Author/s: Masana Marín, Luis
    Keywords: Statins Risk Registry Metaanalysis Lipids Ldl cholesterol Guidelines European-society Efficacy Cholesterol
    Abstract: 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.
    Thematic Areas: Saúde coletiva Nutrição Medicine (all) Medicina ii Medicina i General medicine Epidemiology Engenharias iv Educação física Ciências biológicas ii Ciências biológicas i Ciência de alimentos Cardiology and cardiovascular medicine Cardiac & cardiovascular systems Biotecnología
    licence for use: https://creativecommons.org/licenses/by/3.0/es/
    Author's mail: luis.masana@urv.cat
    Author identifier: 0000-0002-0789-4954
    Record's date: 2024-07-27
    Papper version: info:eu-repo/semantics/publishedVersion
    Link to the original source: https://academic.oup.com/eurjpc/article/28/11/1279/5898664
    Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
    Papper original source: European Journal Of Preventive Cardiology. 28 (11): 1279-1289
    APA: Ray, Kausik K.; Molemans, Bart; Schoonen, W. Marieke; Giovas, Periklis; Bray, Sarah; Kiru, Gaia; Murphy, Jennifer; Banach, Maciej; De Servi, Stefano; (2021). EU-Wide Cross-Sectional Observational Study of Lipid-Modifying Therapy Use in Secondary and Primary Care: the DA VINCI study. European Journal Of Preventive Cardiology, 28(11), 1279-1289. DOI: 10.1093/eurjpc/zwaa047
    Article's DOI: 10.1093/eurjpc/zwaa047
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2021
    Publication Type: Journal Publications
  • Keywords:

    Cardiac & Cardiovascular Systems,Cardiology and Cardiovascular Medicine,Epidemiology
    Statins
    Risk
    Registry
    Metaanalysis
    Lipids
    Ldl cholesterol
    Guidelines
    European-society
    Efficacy
    Cholesterol
    Saúde coletiva
    Nutrição
    Medicine (all)
    Medicina ii
    Medicina i
    General medicine
    Epidemiology
    Engenharias iv
    Educação física
    Ciências biológicas ii
    Ciências biológicas i
    Ciência de alimentos
    Cardiology and cardiovascular medicine
    Cardiac & cardiovascular systems
    Biotecnología
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