2009, Number 1
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Rev Mex Cardiol 2009; 20 (1)
Survey about treatment of dislipidemias with statins in Mexico: Percentage of patients who achieve the therapeutic goal of National Cholesterol Education Program (NCEP)
González CA, Pavía A, Redding FJ, Zacarías JL, Ramírez MA, Alpízar M, Aspe J, Carranza J, Barba R, Ramírez JC, Enciso JM, Rodríguez C, Leyva JL, Cervantes JL, Rubio AF, Hernández HR
Language: Spanish
References: 20
Page: 18-22
PDF size: 123.12 Kb.
ABSTRACT
It is well documented that statins lower LDL-cholesterol levels and prevent cardiovascular events. Notwithstanding there is evidence that in an important proportion of patients, statins do not achieve the recommended LDL-cholesterol levels. Hence, our purpose was to carry out a survey in order to determine the percentage of Mexican patients treated with statins who achieve the therapeutic goal under routine clinical conditions. 676 patients resident in Mexico with diagnosis of dyslipidemia and treated with statins (atorvastatin, sinvastatin, pravastatin, fluvastatin, lovastatin and rosuvastatin) for at least 4 weeks participated in the survey. The proportion of patients achieving the goals defined by the Third Report of The National Cholesterol Education Program (NCEP ATP III), according to their risk category, was recorded. 20.4% of the patients participating in the survey achieved the therapeutic goal. Considering the risk categories, it was observed that 48%, 20% and 12% of the patients in risk categories I, II and III, respectively, achieved the therapeutic goal. As in other populations, an important proportion of Mexican patients with dyslipidemia treated with statins do not achieve the NCEP ATP III goals. Treatment of patients with dyslipedemia must be improved in order to prevent the risk of cardiovascular events.
REFERENCES
Kleemann R, Kooistra T. HMG-CoA reductase inhibitors: effects on chronic subacute inflammation and onset of atherosclerosis induced by dietary cholesterol. Curr Drug Targets Cardiovasc Haematol Disord 2005; 5: 441-453.
Ridker PM. High-sensitivity C-reactive protein and cardiovascular risk: rationale for screening and primary prevention. Am J Cardiol 2003; 92: 17K-22K.
Ross R. Atherosclerosis-an inflammatory disease. N Engl J Med 1999; 340: 115-126.
Steinberg D. Atherogenesis in perspective: hypercholesterolemia and inflammation as partners in crime. Nat Med 2002; 8: 1211-1217.
Brown MS, Goldstein. Multivalent feedback regulation of HMG CoA reductase, a control mechanism coordinating isoprenoid synthesis and cell growth. J Lipid Res 1980; 21: 505-517.
Liao JK, Laufs U. Pleiotropic effects of statins. Annu Rev Pharmacol Toxicol 2005; 45: 89-118.
Miida T, Hirayama S, Nakamura Y. Cholesterol-independent effects of statins and new therapeutic targets: ischemic stroke and dementia. J Atheroscler Thromb 2004; 11: 253-264.
Laufs U, La Fata V, Plutzky J, Liao JK. Upregulation of endothelial nitric oxide synthase by HMG CoA reductase inhibitors. Circulation 1998; 97: 1129-1135.
LaRosa JC, He J, Vupputuri S. Effect of statins on risk of coronary disease: a meta-analysis of randomized controlled trials. J Am Med Assoc 1999; 282: 2340-2346.
Nagashima H, Kasanuki H. The status of lipid management in 1,836 patients with coronary artery disease: a multicenter survey to evaluate the percentage of Japanese coronary artery disease patients achieving the target low-density lipoprotein cholesterol level specified by the Japan Atherosclerosis Society. J Atheroscler Thromb 2005; 12: 338-342.
Schultz JS, O’Donnell JC, McDonough KL, Sasane R, Meyer J. Determinants of compliance with statin therapy and low-density lipoprotein cholesterol goal attainment in a managed care population. Am J Manag Care 2005; 11: 306-312.
Zhou Z, Rahme E, Abrahamowicz M et al. Effectiveness of statins for secondary prevention in elderly patients after acute myocardial infarction: an evaluation of class effect. Can Med Assoc J 2005; 172: 1187-1194.
Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults: Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). J Am Med Assoc 2001; 285: 2486-2497.
McKenney JM. Lipid management: tools for getting to the goal. Am J Manag Care 2001; 7: S299-S306.
Frolkis JP, Pearce GL, Sprecher DL. Impact of nonprescriptive factors on low-density lipoprotein cholesterol reduction with statins. Am J Cardiol 2004; 94: 1310-1312.
Parris ES, Lawrence DB, Mohn LA, Long LB. Adherence to statin therapy and LDL cholesterol goal attainment by patients with diabetes and dyslipidemia. Diabetes Care 2005; 28: 595-599.
Pearson TA, Laurora I, Chu H, Kafonek S. The lipid treatment assessment project (L-TAP): a multicenter survey to evaluate the percentages of dyslipidemic patients receiving lipid-lowering therapy and achieving low-density lipoprotein cholesterol goals. Arch Intern Med 2000; 160: 459-467.
Straka RJ, Taheri R, Cooper SL, Tan AW, Smith AC. Assessment of hypercholesterolemia control in a managed care organization. Pharmacotherapy 2001; 21: 818-827.
Kuo YF, Raji MA, Markides KS, Ray LA, Espino DV, Goodwin JS. Inconsistent use of diabetes medications, diabetes complications, and mortality in older mexican americans over a 7-year period data from the hispanic established population for the epidemiologic study of the elderly. Diabetes Care 2003; 26: 3054-3060.
Schachter M. Chemical, pharmacokinetic and pharmacodynamic properties of statins: an update. Fundam Clin Pharmacol 2005; 19: 117-125.