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1.
Wien Med Wochenschr ; 163(23-24): 528-35, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23979353

RESUMO

UNLABELLED: Low density lipoprotein (LDL-C) levels determine the cardiovascular risk. Previous studies indicated an LDL-C target attainment of around 50%, but no Austrian wide analysis on results for the federal states was available. We therefore sought to detect potential differences. DESIGN: Open-label, non-interventional, longitudinal study, registered: www.clinicaltrials.gov NCT 01381679. In all, 746 statin treated patients not at LDL-C goal received intensified therapy for 12 months. The sample was split into nine subgroups, representing the federal states of Austria.We detected an east-west gradient for baseline LDL-C. Individual target values were achieved by 37.2% (range: 26.1-57.7%). After 12 months, LDL-C < 70 mg/l was achieved by 13.5% (5.9-38.5%). Univariate ANCOVA retrieved significant differences within the states (Upper Austria and Salzburg, p = 0.001 and p = 0.0015, respectively). Furthermore, the capacity of intensified lipid lowering therapy applied in practice was as high as -42% as compared to previous standard therapy (additional LDL-C reduction after switch from baseline therapy in Vorarlberg).


Assuntos
Anticolesterolemiantes/uso terapêutico , Azetidinas/uso terapêutico , LDL-Colesterol/sangue , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Hipercolesterolemia/sangue , Hipercolesterolemia/tratamento farmacológico , Idoso , Áustria , Estudos Transversais , Resistência a Medicamentos , Ezetimiba , Feminino , Humanos , Hipercolesterolemia/epidemiologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Retratamento , Topografia Médica
2.
Wien Klin Wochenschr ; 128 Suppl 2: S216-28, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27052248

RESUMO

In 2010, eight Austrian medical societies proposed a joint position statement on the management of metabolic lipid disorders for the prevention of vascular complications. An updated and extended version of these recommendations according to the current literature is presented, referring to the primary and secondary prevention of vascular complications in adults, taking into consideration the guidelines of other societies. The "Austrian Lipid Consensus - 2016 update" provides guidance for individualized risk stratification and respective therapeutic targets, and discusses the evidence for reducing vascular endpoints with available lipid-lowering therapies. Furthermore, specific management in key patient groups is outlined, including subjects presenting with coronary, cerebrovascular, and/or peripheral atherosclerosis; diabetes mellitus and/or metabolic syndrome; nephropathy; and familial hypercholesterolemia.


Assuntos
Hipolipemiantes/administração & dosagem , Transtornos do Metabolismo dos Lipídeos/complicações , Transtornos do Metabolismo dos Lipídeos/terapia , Guias de Prática Clínica como Assunto , Doenças Vasculares/etiologia , Doenças Vasculares/prevenção & controle , Áustria , Cardiologia/normas , Medicina Baseada em Evidências , Humanos , Transtornos do Metabolismo dos Lipídeos/diagnóstico , Resultado do Tratamento , Doenças Vasculares/diagnóstico
3.
Curr Med Res Opin ; 28(9): 1447-54, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22856551

RESUMO

OBJECTIVE: Lowering low-density lipoprotein cholesterol (LDL-C) levels can reduce vascular clinical endpoints in outcome studies. Despite this evidence, previous cross-sectional analyses reported a mean LDL-C target attainment of <50%. This non-interventional, longitudinal study aimed to asses the rate of target attainment by intensified LDL-C lowering therapy in a high-risk population under routine medical care. DESIGN: This was an open-label, non-interventional, observational, non-comparative longitudinal study. METHODS: A total of 1682 outpatients at high cardiovascular risk, not at LDL-C target despite statin therapy, were documented. Treating physicians administered an intensified therapy at their discretion. In all, 794 patients completed all the examinations at baseline after 3 and 12 months. The achieved LDL-C reductions was evaluated based on expert consensus reflecting the 2007 guidelines issued by the European Society of Cardiology (ESC) on cardiovascular disease prevention. REGISTRATION: www.clinicaltrials.gov , identification number NCT 01381679 RESULTS: In the study, 40.3% achieved the individual LDL-C target of <.8 mmol/L (70 mg/dl) or <2.5 mmol/L (100 mg/dl); 73% received a simvastatin/ezetimibe fixed-dose combination; 3% received add-on ezetimibe and 23% statin therapy at maintained or increased doses; 1% received no drug treatment at all. LDL-C declined after 12 months by -31.0% (ratio 0.69, 95% CI 0.67-0.71, p<0.001), triglycerides by -11.8% (ratio 0.88, 95% CI 0.85-0.91, p<0.01) and high-density lipoprotein cholesterol (HDL-C) increased by 11.9% (ratio 1.12, 95% CI 1.10-1.14, p<0.01). CONCLUSION: Intensified therapy was effective, but target attainment was still low at 40.3% or 13.9% with regard to the new 2011 guidelines issued by the European Atherosclerosis Society (EAS) and the ESC on dyslipidemias. Enhanced screening of LDL-C levels and the use of statins at highest tolerated dose and concomitant combination therapy is recommended in order to achieve LDL-C targets outlined by current guidelines. Limitations include the design as a non-interventional study. However, this study reflects real life conditions.


Assuntos
LDL-Colesterol/sangue , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Hipercolesterolemia/tratamento farmacológico , Estudos Longitudinais , Fatores de Risco
4.
Wien Med Wochenschr ; 153(1-2): 6-13, 2003.
Artigo em Alemão | MEDLINE | ID: mdl-12621684

RESUMO

In the past years, research on cardiovascular prevention was among the fields with the most pronounced medical progress. Actually, a substantial proportion of strokes could be avoided given a strict consideration of the currently available prevention guidelines. The current review summarizes the most compelling studies and meta-analyses on this issue and depicts the main consequences and resulting recommendations. Apart from classic risk factors there is a special focus on new risk concepts including toxic effects of homocystine, the 'iron hypothesis' and the intriguing issues of inflammation and chronic infection. In addition, there will be a dispute on challenges regarding carotid surgery and optimal drug therapy as well as on dietary guidelines.


Assuntos
Acidente Vascular Cerebral/prevenção & controle , Medicina Baseada em Evidências , Comportamentos Relacionados com a Saúde , Humanos , Estilo de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Risco , Acidente Vascular Cerebral/etiologia
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