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The Impact of the 2019 European Guideline for Cardiovascular Risk Management: A Cross-Sectional Study in General Practice

Authors :
Meier, Rahel; https://orcid.org/0000-0001-8159-9753
Rachamin, Yael
Rosemann, Thomas; https://orcid.org/0000-0002-6436-6306
Markun, Stefan
Meier, Rahel; https://orcid.org/0000-0001-8159-9753
Rachamin, Yael
Rosemann, Thomas; https://orcid.org/0000-0002-6436-6306
Markun, Stefan
Source :
Meier, Rahel; Rachamin, Yael; Rosemann, Thomas; Markun, Stefan (2020). The Impact of the 2019 European Guideline for Cardiovascular Risk Management: A Cross-Sectional Study in General Practice. Journal of Clinical Medicine, 9(7):2140.
Publication Year :
2020

Abstract

The aim of this study was to assess the impact of the 2019 published European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guideline on cardiovascular (CV) risk management compared with its predecessor from 2016 in a cohort in general practice. We performed a cross-sectional retrospective study with data from electronic medical records. The study cohort included 103,351 patients with known CV risk. We assessed changes in CV risk classification and low-density lipoprotein cholesterol (LDL-C) target values, the impact on LDL-C achievement rates, and the current lipid-lowering treatments. Under the 2019 ESC guideline, CV risk categories changed in 27.5% of patients, LDL-C target levels decreased in 71.4% of patients, and LDL-C target achievement rate dropped from 31.1% to 16.5%. Among non-achievers according to the 2019 guideline, 52.2% lacked lipid-lowering drugs entirely, and 41.5% had conventional drugs at a submaximal intensity. Of patients in the high-risk and very high-risk categories, at least 5% failed to achieve the LDL-C target level despite treatment at maximal intensity with conventional lipid-lowering drugs, making them eligible for PCSK-9 inhibitors. In conclusion, the 2019 ESC/EAS guideline lowered LDL-C target values for the majority of patients in general practice and halved LDL-C target achievement rates. There is still a large undeveloped potential to lower CV risk by introducing conventional lipid-lowering drugs, particularly in patients at high or very high CV risk. A substantial proportion of the patients can only achieve their LDL-C targets using PCSK-9 inhibitors, which would currently require an at least 10-fold increase in prescribing of these drugs.

Details

Database :
OAIster
Journal :
Meier, Rahel; Rachamin, Yael; Rosemann, Thomas; Markun, Stefan (2020). The Impact of the 2019 European Guideline for Cardiovascular Risk Management: A Cross-Sectional Study in General Practice. Journal of Clinical Medicine, 9(7):2140.
Notes :
application/pdf, info:doi/10.5167/uzh-188465, English
Publication Type :
Electronic Resource
Accession number :
edsoai.on1443031643
Document Type :
Electronic Resource