Cardiovascular disease; cholesterol; diabetes; hypertension; statins; Cardiology and Cardiovascular Medicine; General Medicine
Abstract :
[en] [en] BACKGROUND: Cardiovascular disease (CVD) is one of the leading causes of death in Belgium. Current strategies for the prevention and management of CVD focus on reducing low-density lipoprotein cholesterol (LDL-C) levels. This analysis assessed whether LDL-C goals, recommended by the European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guidelines, were being achieved in a Belgian study population.
METHODS: The cross-sectional, observational, DA VINCI study enrolled patients prescribed lipid-lowering therapy (LLT) between 21 June 2017 and 20 November 2018. Data for patients from Belgium were extracted for this country-specific analysis. Primary endpoint was the proportion of patients who achieved 2016 ESC/EAS risk-based LDL-C goals; attainment of 2019 risk-based LDL-C goals was evaluated post hoc.
RESULTS: Of 497 enrolled patients, 41% were female and mean age was 68 years. Among subjects with an LDL-C measurement on stabilised LLT, moderate-intensity statin monotherapy was the most prescribed LLT regimen (59%). Overall, 63% of patients achieved their risk-based LDL-C goals according to the 2016 ESC/EAS guidelines. Among patients with established ASCVD, risk-based LDL-C goal attainment was higher in patients with peripheral arterial disease (53%) than patients with coronary (37%) and cerebrovascular disease (42%). According to the updated 2019 ESC/EAS guidelines, less than half (41%) of patients achieved their risk-based LDL-C goal. The proportion of primary and secondary prevention patients who achieved 2019 risk-based LDL-C goals was 59% and 18%, respectively.
CONCLUSION: These findings reveal a large gap between the LDL-C goals advocated by the ESC/EAS and the levels achieved in routine clinical practice in Belgium.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
van de Borne, Philippe; Department of Cardiology, Erasme Hospital, University Libre of Brussels, Brussels, Belgium
Peeters, André; Department of Neurology, Saint Luc University Clinic, Brussels, Belgium
Janssens, Luc; Department of Cardiology, Imelda Hospital, Bonheiden, Belgium
Leone, Attilio; Department of Cardiology, Tivoli University Hospital Centre, La Louvière, Belgium
Lemmens, Robin; Department of Neurology, University Hospitals Leuven and KU Leuven, Leuven, Belgium
Verhaegen, Ann; Department of Endocrinology, Diabetes and Metabolism, Antwerp University Hospital, Edegem, Belgium
De Meulemeester, Marc; GP, Private Practice, Gozée, Belgium
The authors thank Natasha Rangwani, PhD, of PharmaGenesis London, London, UK, for medical writing support. The authors also acknowledge Dr. Gaia Kiru, Dr. Jennifer Murphy and Mrs. Amanda Bravery from Imperial College London for the additional support and K.K.R. acknowledges his support by the NIHR Imperial Biomedical Research Centre
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