斯洛伐克高风险患者群体中LDL胆固醇目标水平达标进展
Progress in Achieving LDL Cholesterol Target Levels in a High-Risk Patient Population in Slovakia.
摘要(中文译文)
斯洛伐克血脂异常的管理近年来发生了显著变化，尤其是通过放宽现有药物的处方限制以及引入新的创新分子药物。达到低密度脂蛋白胆固醇（LDL-C）目标水平在预防动脉粥样硬化相关心血管（CV）疾病的发生和进展中起着关键作用。本研究旨在分析这些变化如何影响极高心血管风险患者达到目标LDL-C水平的有效性。本项目为一项回顾性分析，利用合作的国家级实验室数据，对2020年至2023年的匿名LDL-C值进行分析。纳入的患者为诊断为急性冠脉综合征（ACS）、卒中的患者，以及更广泛地讲，具有高和极高心血管风险的患者。目标LDL-C值依据2019年ESC/EAS指南进行评估。在四年研究期间，共评估了来自115,950名患者的363,020份LDL-C检测记录。在诊断为ACS的患者中，2020-2023年各观察年度分别有2.2%-5%达到目标LDL-C水平。高达6.5%-7.4%的患者LDL-C水平≥4.9 mmol/L。对于卒中患者，仅4%-6.6%达到目标LDL-C水平，而5.6%-6.7%的患者水平≥4.9 mmol/L。在极高心血管风险组中，仅1.7%-3%达到目标水平，7.5%-8.7%具有极高的LDL-C水平≥4.9 mmol/L。尽管取得了这些适度改善，但在2023年，表现最佳亚组中仍有超过93.4%的患者未能达到指南的绝对目标阈值。尽管处方限制的解除和创新治疗的引入与绝对达标率翻倍及极端高胆固醇血症的收缩相关，但斯洛伐克的总体控制情况仍严重不足。迫切需要系统化、方案驱动的联合治疗方案和强化随访。
Abstract
The management of dyslipidaemia in Slovakia has undergone significant changes in recent years, particularly through the relaxation of prescription restrictions for existing medications and the introduction of new innovative molecules. Achieving target levels of LDL cholesterol (LDL-C) plays a key role in preventing the onset and progression of atherosclerosis-related cardiovascular (CV) diseases. The aim of this study was to analyse how these changes have affected the effectiveness of reaching target LDL-C levels in patients at very high CV risk. This project was conducted as a retrospective analysis of anonymised LDL-C values from 2020 to 2023 using data from a collaborating nationwide laboratory. Patients included were those diagnosed with acute coronary syndrome (ACS), stroke, and, more generally, those with high and very high CV risk. Target LDL-C values were assessed based on the 2019 ESC/EAS guidelines. A total of 363,020 LDL-C test records from 115,950 patients were evaluated over the four-year study period. Among patients diagnosed with ACS, 2.2-5% achieved target LDL-C levels in the respective years of observation 2020-2023. As many as 6.5-7.4% had LDL-C levels ≥ 4.9 mmol/L. For patients with stroke, only 4-6.6% reached target LDL-C levels, while 5.6-6.7% had levels ≥ 4.9 mmol/L. In the group with very high CV risk, only 1.7-3% achieved target levels, and 7.5-8.7% had extremely high LDL-C levels ≥ 4.9 mmol/L. Despite these modest improvements, over 93.4% of patients in the highest-performing subgroup failed to reach the absolute guideline target threshold in 2023. While the lifting of prescription constraints and the introduction of innovative treatments correlates with a doubling of absolute target attainment and a contraction of extreme hypercholesterolemia, overall control remains critically low in Slovakia. Systematic, protocol-driven combination regimens and intensive follow-up are urgently needed.
如何引用
AMA
Stefan Toth, Lukas Olsavsky, Pavol Fulop, Mariana Dvoroznakova, Martin Sevcik, Natalia Vanova, et al. Progress in Achieving LDL Cholesterol Target Levels in a High-Risk Patient Population in Slovakia.. Diagnostics (Basel, Switzerland). 2026; doi:10.3390/diagnostics16131980.
APA
Stefan Toth, Lukas Olsavsky, Pavol Fulop, Mariana Dvoroznakova, Martin Sevcik, Natalia Vanova, et al (2026). Progress in Achieving LDL Cholesterol Target Levels in a High-Risk Patient Population in Slovakia.. Diagnostics (Basel, Switzerland). https://doi.org/10.3390/diagnostics16131980
GB/T 7714
Stefan Toth, Lukas Olsavsky, Pavol Fulop, Mariana Dvoroznakova, Martin Sevcik, Natalia Vanova, et al. Progress in Achieving LDL Cholesterol Target Levels in a High-Risk Patient Population in Slovakia.[J]. Diagnostics (Basel, Switzerland), 2026 doi:10.3390/diagnostics16131980.
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