[高胆固醇血症的一级和二级预防:PROCYON试验中与患者护理相关的差异]。

Pub Date : 2023-09-01 Epub Date: 2023-08-21 DOI:10.1055/a-2117-6504
Umidakhon Makhmudova, Michaela Wolf, Kathy Willfeld, Lea Beier, Oliver Weingärtner
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引用次数: 0

摘要

背景:在德国,心血管疾病占死亡人数的三分之一。低密度脂蛋白胆固醇(LDL-C)水平升高被认为是一个主要的危险因素。因此,降低LDL-C水平是预防心血管事件的一个组成部分。方法:这项工作的目的是通过对PROCYON调查的横断面数据进行事后比较,确定一级预防(PP)和二级预防(SP)之间的潜在差异。询问与高胆固醇血症相关的病史、伴随疾病、依从性和疾病意识。结果:5494名患者参加了调查(PP:3798;SP:1696)。结果比较显示,女性比例更高(PP 70.7%对SP 42.5%),合并症更常见,如高血压(PP 45.6%对SP 61.0%)、肥胖(PP 20.9%对SP 27.4%)和2型糖尿病(PP 14.1%对SP 23.8%),诊断最常见于心血管相关住院期间(SP 58.0%)。分别有16.3%(PP)和54.0%(SP)的患者咨询了心脏病专家。二级预防组至少每半年进行一次LDL-C检查(PP 46.8%对SP 77.9%)和药物干预(PP 43.0%对SP 87.0%)的频率更高。此外,观察到在生活方式改变的实施、LDL-C水平的改善、治疗的调整以及依从性、治疗满意度和患者知识方面的差异。结论:PROCYON调查的一级预防和二级预防的比较显示,二级预防组总体上更好地利用了治疗方案,护理强度更高。然而,两组患者仍有很大的改善潜力,以确保有效预防心血管事件。
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[Primary and secondary prevention in hypercholesterolemia: differences relevant to patient care in the PROCYON trial].

Background: Cardiovascular disease accounts for one third of deaths in Germany. Elevated levels of low-density lipoprotein cholesterol (LDL-C) are considered a major risk factor. Lowering LDL-C levels is therefore an integral part of the prevention of cardiovascular events.

Methods: The aim of this work is to identify potential differences between primary prevention (PP) and secondary prevention (SP) by means of a post-hoc comparison of cross-sectional data from the PROCYON survey. Medical history, concomitant diseases, adherence, and disease awareness in relation to hypercholesterolemia were queried.

Results: 5,494 patients had participated in the survey (PP: 3,798; SP: 1,696). Comparison of the results showed a numerically higher proportion of women (PP 70.7% vs. SP 42.5%) as well as more frequent comorbidities such as hypertension (PP 45.6% vs. SP 61.0%), obesity (PP 20.9% vs. SP 27.4%), and type 2 diabetes mellitus (PP 14.1% vs. SP 23.8%). In primary prevention, hypercholesterolemia was most often diagnosed during screening (PP 74.6%), and in secondary prevention, the diagnosis was most often made during cardiovascular-related hospitalization (SP 58.0%). A cardiologist was consulted by 16.3% (PP) and 54.0% (SP) of patients, respectively. At least semiannual LDL-C checks (PP 46.8% vs. SP 77.9%) and drug intervention (PP 43.0% vs. SP 87.0%) were more frequent in the secondary prevention group. In addition, differences in the implementation of lifestyle changes, improvement of LDL-C levels, adjustment of therapy as well as adherence, treatment satisfaction and patient knowledge were observed.

Conclusion: The comparison of primary and secondary prevention from the PROCYON survey shows overall better utilization of treatment options and higher intensity of care in the secondary prevention group. However, there is still great potential for improvement in both groups to ensure efficient prevention of cardiovascular events.

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