Artikel
Adequate use of statins in Germany?: Results from a registry
Suche in Medline nach
Autoren
Veröffentlicht: | 30. September 2004 |
---|
Gliederung
Text
Context
EUROASPIRE studies showed that a guideline-oriented treatment of risk factors for cardiovascular events (CE) is not performed consequently.
Aim of the Study
Evaluation of risk factors and risk for CE calculated by PROCAM-algorithm of patients starting statin therapy and during follow-up of 6 weeks and 9 months.
Material and Methods
52905 statin-naive patients [aged 35-65 years, 46.3 % women] starting statin therapy from 4401 practices were recruited: anamnestic risk factors: positive family history of CHD 56.7 %, angina pectoris 35.9 %, myocardial infarction / PTCA 19.9 %, stroke / TIA 8.0 %, peripheral arterial disease 11.1 %, diabetes mellitus 24.2 %, smoker 26.7 %. Mean age was 56.5 years (men 55.7 y, women 57.4 y), mean body mass index: 27.2 (men 27.3, women 27.1), mean blood pressure 141/84 mmHg (men 141/83 mmHg, women 141/83 mmHg).
Results
In 50.6 % of men and 37.2 % of women statin therapy was initiated as part of secondary prevention. In the primary prevention group, 17.4 % of men and 0.3 % of women had a risk of CE [within 10 years] > 20 %. Risk factor profile improved during the observation period: blood pressure (systolic / diastolic in mmHg) 140.5 / 83.5 to 135.7 / 81.5, mean total cholesterol (mmol/l) 7.2 to 5.1, mean LDL-cholesterol (mmol/l) 4.8 to 3.4. 52260 patients had complete documentation for the evaluation of goal attainment: after 6 weeks of therapy, LDL-cholesterol target levels (< 2.6 mmol/l) were reached by 13.9 % / 10.9 % (men / women) in secondary prevention, after 9 months 15.1% (men) resp. 12.4 % (women) reached the target level. Initial statin dosage was changed in less than 5 %. In primary prevention 8.0 / 6.2 % men / women at high risk reached LDL-cholesterol target levels < 2.6 mmol/l after 9 months. In 57.3 / 19.4 % women / men, statin treatment was initiated despite a risk for CE of less than 10 % within the next 10 years.
Conclusion
Many patients at high risk for a CE do not achieve the recommended LDL-cholesterol level. On the other hand, many patients with a relatively low risk for CE are treated with statins. Therefore, treating the right patients to target should be improved.
Conflict of interest: The registry was sponsored by MSD.