Proportion of High-Risk/Very High-Risk Patients in Europe with Low-Density Lipoprotein Cholesterol at Target According t
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REVIEW
Proportion of High-Risk/Very High-Risk Patients in Europe with Low-Density Lipoprotein Cholesterol at Target According to European Guidelines: A Systematic Review Eric Bruckert . Klaus Georg Parhofer . Jose Ramon Gonzalez-Juanatey . Børge Nordestgaard . Marcello Arca . Periklis Giovas . Kausik Ray
Received: December 5, 2019 Ó The Author(s) 2020
ABSTRACT Objective: Assess achievement of low-density lipoprotein cholesterol (LDL-C) targets in European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guidelines.
Enhanced Digital Features To view enhanced digital features for this article go to https://doi.org/10.6084/ m9.figshare.11908161. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12325020-01285-2) contains supplementary material, which is available to authorized users. E. Bruckert (&) Endocrinologie Me´tabolisme et Pre´vention Cardiovasculaire, Institut E3M et IHU ˆ pital Pitie´ Salpeˆtrie`re, Cardiome´tabolique (ICAN), Ho Paris, France e-mail: [email protected] K. G. Parhofer Medizinische Klinik IV-Grosshadern, Klinikum der ¨ nchen, Marchioninistr. 15, 81377 Universita¨t Mu Munich, Germany J. R. Gonzalez-Juanatey Cardiology and Intensive Cardiac Care Department, CIBERCV, University Hospital, Santiago de Compostela, Spain B. Nordestgaard Department of Clinical Biochemistry, Faculty of Health and Medical Sciences, Herlev and Gentofte Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark
Design: Systematic literature review. Data Sources: Medline, EMBASE, Cumulated Index to Nursing and Allied Health Literature. Eligibility Criteria: Observational studies reporting LDL-C levels/target attainment, measured between 1 August 2006 to 31 August 2017, in European adults with established cardiovascular disease (CVD), diabetes with target organ damage, familial hypercholesterolaemia (FH) or 10-year risk of fatal CVD C 5% (assessed by Systematic Coronary Risk Evaluation [SCORE]). Data Extraction and Synthesis: Two reviewers independently extracted relevant studies and M. Arca Department of Internal Medicine and Medical Specialties, UOS Atherosclerosis Center, La Sapienza University of Rome, Rome, Italy P. Giovas Amgen Europe GmbH, Rotkreuz, Switzerland K. Ray Department of Public Health and Primary Care, Imperial Centre for Cardiovascular Disease Prevention, Imperial College London, London, UK
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assessed study quality using the Risk of Bias for Non-Randomised Studies–Interventions (ROBINS-I) tool. Primary outcome was the proportion of patients achieving LDL-C targets in the 2011/2016 ESC/EAS guidelines. Where available, patient characteristics were presented as means weighted by sample size. The proportions of patients achieving LDL-C targets in the 5 years before and after publication of the 2011 guidelines were compared using a chi-square test. Results: Across 81 eligible studies (303,534 patients), achievement of LDL-C \ 1.8 mmol/L was poor among patients with established CVD (16%; range 9–56%) and
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