Lipid Modification to Reduce Cardiovascular Risk in Secondary Prevention Patients with Special Emphasis on PCSK9 Inhibitor Requirement: An Analysis Based on Delphi Panel Approach.


Kızılırmak P., Öngen Z., Güleç S., Kayıkçıoğlu M., Kılıçkap M., Abacı A., ...Daha Fazla

Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir, cilt.50, sa.8, ss.554-560, 2022 (ESCI) identifier identifier identifier

Özet

Objective: The aim of this study is to analyze the low-density lipoprotein cholesterol-lowering therapies in secondary prevention patients by anatyzing their plasma low-density lipoprotein cholesterol levels. current treatment, considering their inadequate response to medications (as defined in current guidelines), and the requirement for a protein convertase subtilisin/kexin type 9 inhibitor. Methods: Delphi panel is used to seek expert consensus of experienced 12 cardiologists. A questionnaire consisting of 6 main questions is used to reflect the opinion of the expert panetists on the practices of tow-density lipoprotein cholesterol-lowering therapies of patients with high and very high cardiovascular risk. Patients with atheroscterotic cardiovascutar disease are covered in this present analysis. Results: According to expert opinion data. 18.6% of the patient population with atherosclerotic cardiovascular disease is estimated to have experienced recurrent vascular events. The current treatment of the patient population is 39.7% on high dose. 36.9% on tow/moderate dose of statin, 13.1% on maximum tolerated dose statin + ezetimibe, and 1.2% on maximum tolerated dose statin + ezetimibe + protein convertase subtilisin/kexin type 9 inhibitor. The percentage of atherosclerotic cardiovascular disease patients with inadequate treatment response is estimated to be 20.2% in those using "maximum tolerated dose statin + ezetimibe." The proportion of patients who wilt need to be treated with a protein convertase subtilisin/kexin type 9 inhibitor increases as their low-density lipoprotein cholesterol levels rises from 9.1% in 70-99 mg/dL to 50.8% in >= 160 mg/dL for these patients. Conclusion: According to expert opinion, although a substantial proportion of patients with secondary prevention have not achieved tow-density lipoprotein cholesterol goals, the use of protein convertase subtilisin/kexin type 9 inhibitors is very tow. Since the questionnaire subject to panel discussion did not include any question elaborating the issue. the discrepancy between the recommendation of the related guidelines and Turkish practice needs further studies for the explanation.