Results of analysis of data of the regional lipid register on HMAO – Ugra: adherence to treatment and effectiveness of applied drug therapy
AbstractAim – evaluate the treatment and adherence to hypolipidemic therapy (GLT) in patients with high and very high cardiovascular risk (CVD) according to the regional lipid register of Surgut Cabinet Lipid Disorders (UFO, as part of the Risk Management Center).
Material and methods. 151 patients at high and very high cardiovascular risk, not reaching the target values of low density lipoprotein cholesterol (LDLP) against the background of maximum tolerated doses of GLT were analyzed. Of these, 57 (38%) patients had family hypercholesterolemia. Failure to reach the target LDLP values against the background of oral lipid reducing therapy was indicated for PCSK9 inhibitors (alirokumab or evolocumab) in 26 (17%) patients.
Results. 90% of patients were treated with statins of varying intensity. Combined high-intensity therapy was recommended by 49% of patients of the CFSR, 25% of patients of high SSR. Achievement of LDLP targets was observed in 29% of patients in the HSS group, and in 21% of patients in the HSS group. At the control visit, 40% of patients refused to take GLT, independently changed the regimens and doses of statins (including after reaching the target values of LDLP), replaced rosuvastatin with atorvastatin, refused to take esetimib. The results show a lack of adherence to oral lipid reduction therapy in patients with severe lipid abnormalities, including through the presence of statin intolerance. Treatment of patients with the inclusion of PCSK9 inhibitors showed high efficacy, with a significant reduction of LDLP levels by more than 60% from the baseline. In 76% of patients, LDLP targets were achieved against PCSK9 inhibitors.
Conclusion. The achievement of LDLP targets in high and very high risk patients with oral lipid reduction therapy remains insufficient in clinical practice. Prescription of hypolipidemic drugs from the PCSK9 inhibitor group (alirokumab or evolocumab) allows effective achievement of LDLP targets in most patients.
Keywords:cardiovascular risk; lipid registry; lowdensity lipoprotein cholesterol; PCSK9 inhibitors
Funding. The study was carried out at the expense of the state assignment for fundamental scientific research carried out on the basis of the Budgetary Institution of Higher Education of the Khanty-Mansiysk Autonomous Okrug – Ugra “Surgut State University” and exploratory scientific research of the Ministry of Science and Higher Education of the Russian Federation, carried out on the basis of the Federal State Budgetary Institution “Scientific Research Institute for Complex Problems of Cardiovascular Diseases” (PNI 419_12).
Conflict of interest. The authors declare no conflict of interest.
Authors’ contribution. Data analysis, manuscript writing, statistical data processing, approval of the final version, fully responsible for the content – Badamshina L.F.; data interpretation, manuscript writing, editing, approval of the final version, fully responsible for the content – Kashtalap V.V.; data collection, manuscript writing, editing, approval of the final version, fully responsible for the content – Vorobiev A.S.; data collection, manuscript writing, editing, approval of the final version, fully responsible for the content – Kudryavtseva O.V.; contribution to the concept of the study, editing, approval of the final version, fully responsible for the content – Urvantseva I.A.; data collection, manuscript writing, editing, approval of the final version, fully responsible for the content – Astrakhantseva I.D.
Compliance with ethical principles. Before inclusion in the regional lipid registry, all patients signed informed voluntary consent to participate in the observational study.
For citation: Badamshina L.F., Kashtalap V.V., Vorobyev A.S., Kudryavtseva O.V., Urvantseva I.A., Astrakhantseva I.D. Results of analysis of data of the regional lipid register on HMAO – Ugra: adherence to treatment and effectiveness of applied drug therapy. Kardiologiya: novosti, mneniya, obuchenie [Cardiology: News, Opinions, Training]. 2023; 11 (3): 15–22. DOI: https://doi.org/10.33029/2309-1908-2023-11-3-15-22 (in Russian)
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