Achievement of lipid goals in relation to cardiovascular risk stratification in diabetic patients
DOI:
https://doi.org/10.5281/zenodo.13342302Keywords:
Diabetes Mellitus, Cardiovascular diseases, Atherosclerosis, Dyslipidemia, Cardiovascular riskAbstract
Background: Cardiovascular diseases are the main cause of mortality in diabetic individuals. Thus, it is essential that patients always have their cardiovascular risk assessed and that the proposed treatments are guided by this risk. Objectives: To assess the adequacy of lipid targets in relation to cardiovascular risk stratification in diabetic patients. Methods: Cross-sectional study with 377 patients, over 18 years of age and of both sexes, diagnosed with diabetes mellitus and treated between January 2017 and July 2019 in two tertiary hospitals in Passo Fundo, RS. Cardiovascular risks and lipid target adequacy of diabetic patients were classified using the Cardiovascular Risk Stratification Calculator, as recommended in the literature, based on information obtained from medical records. The level of statistical significance was p<0.05. Results: 78.2% of the patients evaluated were outside the recommended lipid target for their cardiovascular risk stratification. Among patients within the target, 62.2% received treatment according to the guideline. Regarding patients outside the target, 33.6% of them received treatment without being recommended by the guideline, and 34.6% did not receive any lipid-lowering treatment. Conclusions: Most of the evaluated diabetic patients are out of the recommended lipid goal. Among the patients within the target, only a little more than half of them received the lipid-lowering treatment recommended by the guideline.
References
BAIGENT, C. et al. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet (London, England), Polônia, v. 376, n. 9753, p. 1670–1681, 2010.
BERTOLUCI, Marcello Casaccia et al. Brazilian guidelines on prevention of cardiovascular disease in patients with diabetes: a position statement from the Brazilian Diabetes Society (SBD), the Brazilian Cardiology Society (SBC) and the Brazilian Endocrinology and Metabolism Society (SBEM). Diabetology & Metabolic Syndrome, Porto Alegre, v. 9, p. 53, 2017.
BREUKER, Cyril et al. Non-achievement of LDL-cholesterol targets in patients with diabetes at very-high cardiovascular risk receiving statin treatment: Incidence and risk factors. International Journal of Cardiology, França, v. 268, p. 195–199, 2018.
CANNON, Christopher P. et al. Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes. The New England Journal of Medicine, Estados Unidos, v. 372, n. 25, p. 2387–2397, 2015.
CARVALHO, Manoel de; VIEIRA, Alan A. Erro médico em pacientes hospitalizados. Jornal de Pediatria, Rio de Janeiro, v. 78, p. 261–268, 2002.
DALLONGEVILLE, Jean et al. Survey of physicians’ practices in the control of cardiovascular risk factors: the EURIKA study. European Journal of Preventive Cardiology, França, v. 19, n. 3, p. 541–550, 2012.
DIAS, A. M. et al. Adesão ao regime Terapêutico na Doença Crónica: Revisão da Literatura. Millenium - Journal of Education, Technologies, and Health, Portugal, n. 40, p. 201‐219-201‐219, 2016.
FERREIRA, Cecília Rafaela Salles. Estratificação de risco na organização do atendimento à saúde da pessoa com Diabetes Mellitus. 2017. 96 f. Dissertação de mestrado - Universidade Federal do Amapá, Amapá, 2017. Disponível em: http://repositorio.unifap.br:80/jspui/handle/123456789/134. Acesso em: 01 jan. 2022.
GANT, Christina M. et al. Real-life achievement of lipid-lowering treatment targets in the DIAbetes and LifEstyle Cohort Twente: systemic assessment of pharmacological and nutritional factors. Nutrition & Diabetes, Holanda, v. 8, n. 1, p. 24, 2018.
GITT, Anselm K. et al. Persistent lipid abnormalities in statin-treated patients and predictors of LDL-cholesterol goal achievement in clinical practice in Europe and Canada. European Journal of Preventive Cardiology, Alemanha, v. 19, n. 2, p. 221–230, 2012.
INTERNATIONAL DIABETES FEDERATION. IDF Diabetes Atlas 2021 | IDF Diabetes Atlas. Bélgica, 2021. Disponível em: https://diabetesatlas.org/atlas/tenth-edition/. .
KHUNTI, Kamlesh et al. Achievement of guideline targets for blood pressure, lipid, and glycaemic control in type 2 diabetes: A meta-analysis. Diabetes Research and Clinical Practice, Bélgica, v. 137, p. 137–148, 2018.
KOTSEVA, Kornelia et al. EUROASPIRE IV: A European Society of Cardiology survey on the lifestyle, risk factor and therapeutic management of coronary patients from 24 European countries. European Journal of Preventive Cardiology, França, v. 23, n. 6, p. 636–648, 2016.
KOTSEVA, Kornelia et al. Lifestyle and impact on cardiovascular risk factor control in coronary patients across 27 countries: Results from the European Society of Cardiology ESC-EORP EUROASPIRE V registry. European Journal of Preventive Cardiology, França, v. 26, n. 8, p. 824–835, 2019.
LEON, Benjamin M.; MADDOX, Thomas M. Diabetes and cardiovascular disease: Epidemiology, biological mechanisms, treatment recommendations and future research. World Journal of Diabetes, Estados Unidos, v. 6, n. 13, p. 1246–1258, 2015.
MINISTÉRIO DA SAÚDE. Relação Nacional de Medicamentos Essenciais: Rename 2020. Brasília, p. 217, 2020.
MOREIRA, Rodrigo O. et al. [Lipid profile of patients with increased risk for cardiovascular events in daily clinical practice]. Arquivos Brasileiros De Endocrinologia E Metabologia, São Paulo, v. 50, n. 3, p. 481–489, 2006.
MOSENZON, Ofri et al. CAPTURE: a multinational, cross-sectional study of cardiovascular disease prevalence in adults with type 2 diabetes across 13 countries. Cardiovascular Diabetology, Israel, v. 20, n. 1, p. 154, 2021.
NOBRE, Fernando; PIERIN, Angela Maria Geraldo; MION JÚNIOR, Décio. Adesão ao tratamento: o grande desafio da hipertensão. São Paulo: Lemos Editorial, 2001.
OLIVEIRA, Dhiãnah S. et al. [Evaluation of cardiovascular risk according to Framingham criteria in patients with type 2 diabetes]. Arquivos Brasileiros De Endocrinologia E Metabologia, Rio de Janeiro, v. 51, n. 2, p. 268–274, 2007.
PETTERLE, Walesca C; POLANCZYK, Carisi Anne. Avaliação crítica dos escores de risco. Revista da Sociedade de Cardiologia do Estado do Rio Grande do Sul, Rio Grande do Sul, v. 23, p. 1–6, 2011.
SAMPAIO, Marcus da Rocha; MELO, Morgan Batista Oliveira de; WANDERLEY, Mary Stefannie Azevedo. Estratificação do risco cardiovascular global em pacientes atendidos numa Unidade de Saúde da Família (USF) de Maceió, Alagoas. Rev. bras. cardiol. (Impr.), Maceió, p. 51–60, 2010.
SANTOS, Maria Cristina Batista dos; GANDOLFI, Lenora. Aderência de pacientes ambulatoriais ao tratamento com estatinas. Rev. bras. cardiol. (Impr.), Brasília, p. 347–355, 2013.
SHEPHERD, James et al. Effect of Lowering LDL Cholesterol Substantially Below Currently Recommended Levels in Patients With Coronary Heart Disease and Diabetes: The Treating to New Targets (TNT) study. Diabetes Care, Reino Unido, v. 29, n. 6, p. 1220–1226, 2006.
SOCIEDADE BRASILEIRA DE CARDIOLOGIA. Home - Calculadora de Risco Cardiovascular. São Paulo, 2017. Disponível em: http://departamentos.cardiol.br/sbc-da/2015/CALCULADORAER2017/index.html. Acesso em: 20 set. 2020.
SOUZA, Keylla Márcia Menezes; MENDONÇA, Francisco Antonio da Cruz. Estratificação de risco de hipertensos e diabéticos em uma unidade de atenção primária de Fortaleza-Ceará. Revista tendências da enfermagem profissional, Fortaleza, v. 8, n. 4, p. 2056–2060, 2016.
TASKINEN, Marja-Riitta; BORÉN, Jan. New insights into the pathophysiology of dyslipidemia in type 2 diabetes. Atherosclerosis, Finlandia, v. 239, n. 2, p. 483–495, 2015.
TAVARES, Noemia Urruth Leão et al. Factors associated with low adherence to medicine treatment for chronic diseases in Brazil. Revista De Saude Publica, Brasília, v. 50, n. suppl 2, p. 10s, 2016.
VACANTI, Luciano J. et al. [Low rate of achieving LDL-cholesterol objective in a low income population]. Arquivos Brasileiros De Cardiologia, Distrito Federal, v. 85, n. 3, p. 162–165, 2005.
WORLD HEALTH ORGANIZATION. Global status report on noncommunicable diseases 2014. Geneva: World Health Organization, 2014. (, v. WHO/NMH/NVI/15.1). Disponível em: https://iris.who.int/handle/10665/148114.
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