Hyperlipidemia management in Slovakia: observational study

Czech version

Authors: Ubomíra Fábryová ^1,2; Alena Nemcová ³
Authors‘ workplace: MetabolKLINIK, s. r. o., Ambulancia pre diabetológiu, poruchy látkovej premeny a výživy, Špecializovaná lipidologická ambulancia, MED PED centrum, Bratislava, Slovenská republika ¹; Biomedicínske centrum SAV, Bratislava, Slovenská republika ²; Amgen Slovakia, s. r. o., Bratislava, Slovenská republika ³
Published in: Vnitř Lék 2019; 65(12): 761-769
Category: Original Contributions

Overview

Aim: A multicountry observational study was conducted to gain insight into the current management of elevated low density lipoprotein cholesterol (LDL-C) in high-risk (HR) and very high-risk (VHR) patients with hyperlipidaemia across central and eastern Europe and Israel. Here we present data from the Slovakian subpopulation.

Methods: We enrolled adult patients who were receiving lipid-lowering therapy (LLT) and attending a specialist (cardiologist/diabetologist/internist) for a routine visit at 9 sites (including academic/specialist centers) across Slovakia. Data were collected retrospectively from patients’ records for the 12 months preceding enrolment.

Results: 150 patients, mean (range) age 62.8 (26–84) years were enrolled, including 24 with familial hypercholesterolemia and 109 secondary prevention patients. Almost all patients (147; 98.0 %) were receiving statins, as monotherapy (114; 76.0 %) or in combination with other LLT (33; 22.0 %): 11 (7.3 %) were classified as having statin intolerance symptoms. Mean LDL-C levels were 3.0 (1.1–7.1) mmol/l at the first, and 2.6 (0.7–7.7) mmol/l at the last, visit of the observation period. Only 2/16 (12.5 %; 95 % CI 1.6–38.4 %) HR patients and 40/134 (29.9 %; 22.3–38.4 %) VHR patients achieved their recommended LDL-C targets of < 2.5 and < 1.8 mmol/l, respectively, during observation. In the FH subset 2/15 (13.3 %; 1.7–40.5 %) HR and 2/9 (22.2 %; 2.8–60.0 %) VHR patients achieved these targets. In patients with definite/probable FH (Dutch Lipid Clinic Network score ≥ 6), these targets were attained by 2/15 (13.3 %; 1.7–40.5) HR patients and 0/6 VHR patients. A total of 41 patients (27.3 %) experienced CV events (≤ 3) during the 12-month observation period.

Conclusion: Our findings provide a picture of patients treated for hyperlipidemia across Slovakia. We found that, despite widespread statin use, a substantial proportion of patients, particularly those with FH, are undertreated and fail to achieve the LDL-C targets recommended in European guidelines. They consequently remain at excess risk of cardiovascular events.

Keywords:

cardiovascular events – dyslipidemias – familial hypercholesterolemia – low-density lipoprotein cholesterol

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