The Evaluation of the Cardiovascular Risk of Patients Using Statins in a University Medical Clinic Outpatient in Belo Horizonte
DOI:
https://doi.org/10.61910/ricm.v8i2.524Keywords:
Cardiovascular risk, Statins, Medical clinic, DyslipidemiasAbstract
Introduction: The primary prevention of cardiovascular diseases is a challenge in the current scenario since, despite the existence of modifiable risk factors, including low-density serum lipoprotein levels, it is estimated that in Brazil, only 58.3% of users of hypolipidemic drugs reach the recommended therapeutic targets. Objective: To report the current state of statin prescription in a secondary-level public clinic and the degree of control according to the cardiovascular risk of patients. Method: This is a cross-sectional retrospective study carried out based on data from the medical records of 170 patients using statins, where cardiovascular risk was assessed using the risk calculator of the Brazilian Society of Cardiology. Results: Of the 170 participants, 66% (113) were classified as “high cardiovascular risk,” of which only 65% (73) were using statins. Patients classified as “very high cardiovascular risk” accounted for 16% (28) of the participants, among whom only 69% (18) were statin users. Furthermore, 69% (117) of the total participants did not reach the intended therapeutic target. Regarding cardiovascular risk classification, there was a significant predominance of patients classified as high-risk. Additionally, it was noted that simvastatin was the most widely used statin in all categories of cardiovascular risk. Conclusion: The results showed that most patients using statins did not reach their therapeutic target based on their cardiovascular risk. Therefore, it is necessary to implement measures such as promoting the continued training of prescribers, motivating the use of cardiovascular risk calculation tools, reassessing patients as needed, and adjusting medications to achieve therapeutic targets.
References
Fonseca HAR, Izar MCO, Drager LF, Pinto IM, Saraiva JFK, Ferreira JFM, et al. Primary Prevention of Cardiovascular Disease at Community Clinics in the State of Sao Paulo, Brazil: Results from the Epidemiological Information Study of Communities. Global Heart. 2023; 18(1):24.
Précoma D.B, Oliveira GM, Simão AF, Dutra OP, Coleho OR, Izar MC, et al. Updated Cardiovascular Prevention Guideline of the Brazilian Society of Cardiology. Arquivos Brasileiros de Cardiologia. 2019; 113(4):787-891.
Oliveira, G.M., Brant LC, Polanczyk CA, Malta DC, Biolo A, Nascimento BR, et al. Cardiovascular Statistics: Brazil 2021. Arquivos Brasileiros de Cardiologia. 2022; 118:115-373.
Rossini E, Biscetti F, Rando MM, Nardella E, Cecchini AL, Nicolazzi MA, et al. Statins in High Cardiovascular Risk Patients: Do Comorbidities and Characteristics Matter? International Journal of Molecular Science. 2022. 23(16):9326.
Mach F, Baigent C, Catapano AL, Koskinas KC, Casula M, Badmon L, et al. ESC/EAS Guidelines for the management of dyslipidemias: lipid modification to reduce cardiovascular risk. 2019. 41(1):111-188.
Hope HF, Binkley GM, Fenton S, Kitas GD, Verstappen SMM, Symmons DPM. Systematic review of the predictors of statin adherence for the primary prevention of cardiovascular disease. Journal Plos One 2019. 14(1).
A Ray KK, Ference BA, Séverin T, Blom D, Nicholls SJ, Shiba MH, et al. World Heart Federation Cholesterol Roadmap. Glob Heart. 202
Ferrari F, Stein R, Motta MT, Moriguchi EH. PCSK9 Inhibitors: Clinical Relevance, Molecular Mechanisms and Safety in Clinical Practice. Arq Bras Cardiol. 2019;4:453-460.
(Z9) Mohamed F, Mansfield B, Raal FJ. Targeting PCSK9 and Beyond for the Management of Low-Density Lipoprotein Cholesterol. Journal of Clinical Medicine. 2023.12(15):5082
(W10) Ray KK, Reeskamp LF, Laufs U, Banach M, Mach F, Tokgözoğlu LS,et al. Combination lipid-lowering therapy as first-line strategy in very high-risk patients. European Heart Journal. 2022. 43(8):830-833
Gomes DA, Paiva MS, Freitas P, Albuquerque F, Lima MR, Santos RR, et al. Atingimento das Metas de Colesterol LDL em Pacientes com Histórico de Infarto Agudo do Miocárdio: Estudo Transversal do Mundo Real. Arquivos Brasileiros de Cardiologia. 2024. 121(1).
Blom DJ, Santos RD, Daclin V, Mercier F, Ruiz AJ, Danchin N, et al. The challenge of multiple cardiovascular risk factor control outside Western Europe: Findings from the International ChoLesterol management Practice Study. European Journal of Preventive Cardiology. 2020;13:1403-1411.
Ingersgaard MV, Andersen TH, Norgaard O, Grabowski D, Olesen K. Reasons for Nonadherence to Statins – A Systematic Review of Reviews. Patient Preference and Adherence. 2020. 14, 675–691.
Santos RD, Pereira C, Cesena F, Laurinavicius AG, Tabone V, Bittencourt MS. Cardiovascular risk misperception and low awareness of familial hypercholesterolemia in individuals with severe hypercholesterolemia. Arq Bras Cardiol. 2021; 116(4):706–712.
Ray KK, Molemans B, Schoonen WM, Giovas P, Bray S, Kiru G, et al. EU-Wide Cross-Sectional Observational Study of Lipid-Modifying Therapy Use in Secondary and Primary Care: the DA VINCI study. European Journal of Preventive Cardiology. 2021. 28(11):1279-1289.
Offiah G, O’Connor C, Kennedy C, Gallagher J, O’Connor P, McAdam B, et al. The DA VINCI study: is Ireland achieving ESC/EAS guideline–directed LDL-C goals? Irish Journal of Medical Science. 2022. 192:1077-1084.
Lázaro P, Murga N, Aguilar D, Hernández-Presa MA. Therapeutic inertia in the outpatient management of dyslipidemia in patients with ischemic heart disease.Rev Esp Cardiol. 2010. 63(12):1428-37.
Blasco M, Pérez Martínez P, Lahoz C. Decalogue of the Spanish Society of Arteriosclerosis to reduce therapeutic inertia. Clin Investig Arterioscler. 2017. 29(5):218-223.
Brug SJ, Khader AO, Atazadah M, Liem AH, Groenemeijer BE, Schut A, et al. The effect of implementing a guideline-based approach to achieve target LDL-C levels in very high-risk patients. The PENELOPE study one year follow-up results. European Heart Journal. 2023:44.
Khader AO, Trier TV, Brug SV, Liem A, Groenemeijer BE, Schut A, et al. Effects of a stepwise, structured LDL-C lowering strategy in patients post-acute coronary syndrome. Netherlands Heart Journal. 2024.
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