在初级预防中,医生感知和计算的心血管风险之间的差异:对LDL-C目标实现和适当的降脂疗法的影响
Arturo Cesaro1,2, Vincenzo Acerbo1,2, Francesco Scialla1,2
1Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Naples, 80131, Italy.
概括
医生经常低估心血管 (CV) 风险,影响预防性护理. 感知和计算的心血管风险之间的这种差异导致他类药物的使用较少,胆固醇目标的实现也较低.
科学领域:
- 心脏病学 心脏病学
- 预防医学 预防医学
- 临床风险评估临床风险评估
背景情况:
- 准确的心血管风险评估对于有效的预防策略至关重要.
- 医生低估心血管风险可能导致不理想的预防措施.
- 初级预防设置需要精确的风险分层来管理患者.
研究的目的:
- 评估医生感知的心血管风险和计算的心血管风险之间的一致性.
- 评估风险感知差异对实现低密度脂蛋白胆固醇 (LDL-C) 目标的影响.
- 在初级预防中分析风险估计和他类药物处方之间的关联.
主要方法:
- 在意大利卡塞尔塔医院对初级预防患者进行的横截面研究.
- 医生感知到的风险由心脏病学家评估;使用SCORE2/SCORE2-OP计算的风险.
- 与科恩卡帕分析的一致性;对于LDL-C目标实现的逻辑回归.
主要成果:
- 感知和计算的心血管风险之间的一致性较差 (科恩卡帕0.208).
- 计算风险发现的非常高风险患者 (86.4%) 显著多于感知风险 (53.5%).
- 低估的心血管风险与较低的LDL-C目标达到 (16%) 和减少使用他类药物 (29.2%) 相关.
结论:
- 在医生感知和计算的心血管风险之间存在显著差异,经常低估.
- 低估心血管风险会对达到LDL-C的目标和启动他类药物治疗产生负面影响.
- 需要改进风险评估工具和医生教育,以优化心血管疾病预防.
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