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. 2021 Apr;116(4):736-741.
doi: 10.36660/abc.20190513.

Statins Prescriptions and Lipid Levels in a Tertiary Public Hospital

[Article in English, Portuguese]
André Schmidt  1 , Henrique Turin Moreira  1 , Gustavo Jardim Volpe  1 , Vamberto B Foschini  1 , Thiago Florentino Lascala  1 , Minna Moreira Dias Romano  1 , Marcus Vinícius Simões  1 , José Ernesto Dos Santos  1 , Benedito Carlos Maciel  1 , José Antonio Marin Neto  1
Affiliations

Statins Prescriptions and Lipid Levels in a Tertiary Public Hospital

[Article in English, Portuguese]
André Schmidt et al. Arq Bras Cardiol. 2021 Apr.

Abstract
in English, Portuguese

Background: The development of a new class of medications that are highly capable of reducing LDL-cholesterol renewed the interest in the characterization of familial hypercholesterolemia patients. Nevertheless, little is known about the lipid profile of patients in tertiary healthcare centers in Brazil in order to better estimate the real occurrence of familial hypercholesterolemia, with initial suspect of LDL-cholesterol levels above 190 mg/d/L.

Objectives: This study evaluated the lipid profile (total cholesterol and LDL-cholesterol) in ambulatory patients from a general tertiary public hospital.

Methods: Retrospective study comparing prescriptions of statins and lipid profile results. The significance level was established in 5%.

Results: In one year, 9,594 individuals received statin prescriptions, of whom 51.5% were females and the mean age was 63.7±12.9 years-old (18 to 100 years-old). Thirty-two medical specialties prescribed statins. Cardiology was responsible for 43% of the total. Nearly 15% of those patients with a prescription did not have a recent total cholesterol result and 1,746 (18%) did not have a recent LDL-cholesterol measurement. The occurrence of the latter between 130 and 190 mg/dL was present in 1,643 (17.1%) individuals, and 228 (2.4%) patients had an LDL-cholesterol ≥190mg/dL among those using statins at distinct doses. Only two statins were used: simvastatin and atorvastatin. The first was prescribed in 77.6% of the prescriptions.

Conclusion: In this cross-sectional cohort at a tertiary general hospital, statins have been widely prescribed but with little success in achieving recognized levels of control. There is probably a significant number of FH individuals in this cohort that need to be properly diagnosed in order to receive adequate treatment due to its prognostic implications.

Fundamento: O surgimento de nova classe de medicamentos com elevada capacidade de reduzir o LDL-colesterol (LDL-c) renovou o interesse na caracterização da hipercolesterolemia familiar (HF). Pouco se conhece do perfil lipídico de pacientes em atendimento terciário em nosso meio para caracterizar a real ocorrência de HF, que começa a ser suspeitada com níveis de LDL-c acima de 190mg/dL.

Objetivos: O estudo avaliou o perfil lipídico (colesterol total [CT] e LDL-c) de pacientes de hospital público terciário.

Métodos: Estudo retrospectivo de avaliação de prescrições de estatinas e resultados dos lipídios. O nível de significância foi estabelecido em 5%.

Resultados: Em 1 ano, 9.594 indivíduos receberam prescrição ambulatorial de estatinas, 51,5% do gênero feminino, idade média de 63,7±12,9 anos (18 a 100 anos). Trinta e duas especialidades prescreveram estatinas, sendo a cardiologia responsável por 43%. Cerca de 15% das prescrições não tinham dosagem recente de CT, e 1.746 (18,0%) não apresentavam resultado recente de LDL-c. A ocorrência de LDL-c > 130mg/dL e < 190mg/dL ocorreu em 1.643 (17,1%) casos, e 228 (2,4%) apresentaram LDL-c ≥ 190mg/dL dentre os que utilizavam estatinas nas diversas doses. Apenas duas estatinas foram utilizadas: sinvastatina e atorvastatina, e a primeira foi prescrita em 77,6% das receitas.

Conclusão: Nesta coorte transversal de hospital terciário, foi possível verificar que a prescrição de estatinas é disseminada, mas que a obtenção de metas adequadas de CT e LDL-c não é atingida em grande percentual, e que há, possivelmente, significativo contingente de portadores de HF que necessitariam ser investigados por suas implicações prognósticas.

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Conflict of interest statement

Potencial conflito de interesses

Os autores declaram não haver conflito de interesses pertinentes.

Figures

Figura 1
Figura 1. Histogramas de distribuição de frequência dos valores absolutos de colesterol total (A) e LDL-c (B) na amostra de pacientes do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP) no ano de 2016.
Figure 1
Figure 1. Histograms of the absolute values of total cholesterol (A) and low-density cholesterol fraction – LDL-c; (B) in the sample of patients from Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, year 2016
See this image and copyright information in PMC

Comment in

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