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[Primary and secondary prevention in hypercholesterolemia: differences relevant to patient care in the PROCYON trial].
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- Author(s): Makhmudova U;Makhmudova U; Wolf M; Wolf M; Willfeld K; Willfeld K; Beier L; Beier L; Weingärtner O; Weingärtner O
- Source:
Deutsche medizinische Wochenschrift (1946) [Dtsch Med Wochenschr] 2023 Sep; Vol. 148 (19), pp. e101-e110. Date of Electronic Publication: 2023 Aug 21.- Publication Type:
English Abstract; Journal Article- Language:
German - Source:
- Additional Information
- Transliterated Title: Primär- und Sekundärprävention bei Hypercholesterinämie – versorgungsrelevante Unterschiede in der PROCYON-Studie.
- Source: Publisher: G. Thieme Country of Publication: Germany NLM ID: 0006723 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1439-4413 (Electronic) Linking ISSN: 00120472 NLM ISO Abbreviation: Dtsch Med Wochenschr Subsets: MEDLINE
- Publication Information: Original Publication: Stuttgart [etc.] : G. Thieme, 1946-
- Subject Terms:
- Abstract: Background: Cardiovascular disease accounts for one third of deaths in Germany. Elevated levels of low-density lipoprotein cholesterol (LDL-C) are considered a major risk factor. Lowering LDL-C levels is therefore an integral part of the prevention of cardiovascular events.
Methods: The aim of this work is to identify potential differences between primary prevention (PP) and secondary prevention (SP) by means of a post-hoc comparison of cross-sectional data from the PROCYON survey. Medical history, concomitant diseases, adherence, and disease awareness in relation to hypercholesterolemia were queried.
Results: 5,494 patients had participated in the survey (PP: 3,798; SP: 1,696). Comparison of the results showed a numerically higher proportion of women (PP 70.7% vs. SP 42.5%) as well as more frequent comorbidities such as hypertension (PP 45.6% vs. SP 61.0%), obesity (PP 20.9% vs. SP 27.4%), and type 2 diabetes mellitus (PP 14.1% vs. SP 23.8%). In primary prevention, hypercholesterolemia was most often diagnosed during screening (PP 74.6%), and in secondary prevention, the diagnosis was most often made during cardiovascular-related hospitalization (SP 58.0%). A cardiologist was consulted by 16.3% (PP) and 54.0% (SP) of patients, respectively. At least semiannual LDL-C checks (PP 46.8% vs. SP 77.9%) and drug intervention (PP 43.0% vs. SP 87.0%) were more frequent in the secondary prevention group. In addition, differences in the implementation of lifestyle changes, improvement of LDL-C levels, adjustment of therapy as well as adherence, treatment satisfaction and patient knowledge were observed.
Conclusion: The comparison of primary and secondary prevention from the PROCYON survey shows overall better utilization of treatment options and higher intensity of care in the secondary prevention group. However, there is still great potential for improvement in both groups to ensure efficient prevention of cardiovascular events.
Competing Interests: MW hat Honorare von der Daiichi-Sankyo Deutschland GmbH erhalten. LB und KW sind Mitarbeiter der Novartis Pharma GmbH. OW erhielt Vortragshonorare und Honorare für Advisory Boards von Sanofi-Aventis, AMGEN, Berlin-Chemie, Amarin Therapeutics, Novartis, Akcea Therapeutics, Pfizer, Daiichi-Sankyo und Hexal GmbH. Er erhielt Reiseunterstützung von der DGFF (Deutsche Lipid-Liga), der DACH Gesellschaft für Prävention e.V. und der Deutschen Gesellschaft für Kardiologie (DGK) sowie Forschungsunterstützung von der Carl von Ossietzky Universität Oldenburg und der Deutschen Gesellschaft für Kardiologie (DGK). UM erhielt Vortragshonorar sowie Reiseunterstützung von der DGFF (Deutsche Lipid-Liga) und Honorar von Sanofi. Die Umfrage, die redaktionelle Unterstützung und die Kosten für die Open-Access-Publikation wurden von der Novartis Pharma GmbH finanziert.
(The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).) - References: Atherosclerosis. 2020 Jan;293:11-17. (PMID: 31821958)
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Nutr Clin Pract. 2010 Oct;25(5):555-7. (PMID: 20962316) - Contributed Indexing: Local Abstract: [Publisher, German] Herz-Kreislauf-Erkrankungen sind für ein Drittel der Todesfälle in Deutschland verantwortlich. Erhöhte Spiegel des Low-Density-Lipoprotein-Cholesterols (LDL-C) gelten als ein wesentlicher Risikofaktor. Die Senkung des LDL-C-Spiegels ist daher integraler Bestandteil der Prävention kardiovaskulärer Ereignisse. [Publisher, German] Ziel dieser Arbeit ist es, in einer post-hoc ausgeführten Gegenüberstellung von Querschnittsdaten aus der Umfrage PROCYON potenzielle Unterschiede zwischen der Primärprävention (PP) und der Sekundärprävention (SP) zu identifizieren. Es wurden Anamnese, Begleiterkrankungen, Adhärenz und Krankheitsbewusstsein in Bezug auf die Hypercholesterinämie abgefragt. [Publisher, German] An der Befragung nahmen 5494 Patient*innen teil (PP: 3798; SP 1696). Der Vergleich der Ergebnisse zeigte einen numerisch höheren Anteil von Frauen (PP 70,7% vs. SP 42,5%) sowie häufigere Komorbiditäten wie Bluthochdruck (PP 45,6% vs. SP 61,0%), Adipositas (PP 20,9% vs. SP 27,4%) und Diabetes mellitus Typ 2 (PP 14,1% vs. SP 23,8%). In der Primärprävention wurde die Hypercholesterinämie-Diagnose zumeist in der Vorsorgeuntersuchung gestellt (PP 74,6%), in der Sekundärprävention geschah dies am häufigsten im Laufe eines kardiovaskulär bedingten Krankenhausaufenthalts (SP 58,0%). Ein/e Kardiolog*in wurde von 16,3% (PP) bzw. 54,0% (SP) konsultiert. Mindestens halbjährliche LDL-C-Kontrollen (PP 46,8% vs. SP 77,9%) sowie eine medikamentöse Intervention (PP 43,0% vs. SP 87,0%) waren in der Sekundärpräventionsgruppe häufiger. Außerdem zeigten sich Unterschiede in der Umsetzung von Veränderungen im Lebensstil, der Verbesserung der LDL-C-Werte, der Anpassung der Therapie sowie der Adhärenz, Therapiezufriedenheit und Informiertheit der Patient*innen. [Publisher, German] Der Vergleich der Primär- und Sekundärprävention aus der Umfrage PROCYON zeigt insgesamt eine bessere Ausschöpfung der Therapieoptionen und eine höhere Versorgungsintensität in der Gruppe der Sekundärprävention. In beiden Gruppen besteht jedoch noch großes Verbesserungspotenzial, um eine effiziente Prävention kardiovaskulärer Ereignisse sicherzustellen.
- Accession Number: 0 (Cholesterol, LDL)
- Publication Date: Date Created: 20230821 Date Completed: 20230918 Latest Revision: 20240320
- Publication Date: 20240320
- Accession Number: PMC10946085
- Accession Number: 10.1055/a-2117-6504
- Accession Number: 37604168
- Transliterated Title:
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