scholarly journals Guideline Concordance of Statin Treatment Decisions: A Retrospective Cohort Study

2020 ◽  
Vol 9 (11) ◽  
pp. 3719
Author(s):  
Yael Rachamin ◽  
Stefan Markun ◽  
Thomas Grischott ◽  
Thomas Rosemann ◽  
Rahel Meier
Keyword(s):  
Cohort Study ◽  
Cardiovascular Risk ◽  
General Practitioners ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Small Deviation ◽  
Statin Treatment ◽  
Treatment Decisions ◽  
High Cardiovascular Risk ◽  
Very High

Guidelines recommend initiation of statins depending on cardiovascular risk and low-density lipoprotein cholesterol (LDL-C) levels. In this retrospective cohort study, we aimed to assess guideline concordance of statin treatment decisions and to find determinants of undertreatment in Swiss primary care in the period 2016–2019. We drew on electronic medical records of 8060 statin-naive patients (50.0% female, median age 59 years) with available LDL-C levels and cardiovascular risk. Guideline concordance was assessed based on the recommendations of the European Society of Cardiology, and multilevel logistic regression was performed to find determinants of undertreatment. We found that statin treatment was initiated in 10.2% of patients during one year of follow up. Treatment decisions were classified as guideline-concordant in 63.0%, as undertreatment in 35.8% and as overtreatment in 1.2%. Among determinants of undertreatment were small deviation from LDL-C treatment thresholds (odds ratio per decrease by 1 mmol/L: 2.09 [95% confidence interval 1.87–2.35]), high compared with very high cardiovascular risk (1.64 [1.30–2.05]), female sex (1.31 [1.05–1.64]), and being treated by older general practitioners (per 10 year decrease: 0.74 [0.61–0.90]). In conclusion, undertreatment of patients at high or very high cardiovascular risk was common, but general practitioners considered cardiovascular risk and LDL-C in their treatment decisions.

Implications of Hidradenitis Suppurativa Phenotypes in Cardiovascular Risk and Treatment Decisions: A Retrospective Cohort Study

Dermatology ◽  
2021 ◽  
pp. 1-6
Author(s):  
Carlos Cuenca-Barrales ◽  
Trinidad Montero-Vilchez ◽  
Luis Salvador-Rodríguez ◽  
Manuel Sánchez-Díaz ◽  
Salvador Arias-Santiago ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cardiovascular Risk ◽  
Disease Severity ◽  
Retrospective Cohort Study ◽  
Therapeutic Approach ◽  
Retrospective Cohort ◽  
Hidradenitis Suppurativa ◽  
Severe Disease ◽  
Treatment Decisions ◽  
Lesion Pattern

<b><i>Background:</i></b> New integrative hidradenitis suppurativa (HS) lesion pattern phenotypes have been proposed, an inflammatory phenotype (IP) and a follicular phenotype (FP). They are characterized by different lesion patterns, symptoms, and risks of disease progression. <b><i>Objectives:</i></b> To evaluate whether lesion pattern phenotypes (1) have a different cardiovascular risk factor profile, and (2) are associated with a different therapeutic approach in the setting of an HS clinic. <b><i>Methods:</i></b> A retrospective cohort study was conducted on 233 patients with HS. They were classified according to lesion pattern phenotype criteria. Data regarding cardiovascular risk factors and treatment decisions were gathered. <b><i>Results:</i></b> One hundred and seventeen HS patients (50.21%) were classified as FP and 112 (48.07%) as IP. IP was associated with more severe disease and greater impairment of quality of life. Regardless of disease severity, patients with IP may have a higher cardiovascular risk, assessed according to higher C-reactive protein (CRP) levels (12.75 vs. 5.89, <i>p</i> = 0.059). The lesion pattern phenotype also influenced treatment decisions regardless of disease severity. Patients with IP were more likely to be treated with systemic corticosteroids and adalimumab, showing that lesion pattern phenotypes are associated with different therapeutic approaches. <b><i>Conclusions:</i></b> IP is associated with higher CRP values, suggesting a greater cardiovascular risk in these patients and also a different therapeutic approach. This information could help guide dermatologists in the management of HS patients and help to determine future treatment recommendations.

Role of nurse practitioners in reducing cardiovascular risk factors: a retrospective cohort study

2015 ◽  
Vol 24 (21-22) ◽  
pp. 3077-3083 ◽  
Author(s):  
Zalika Klemenc-Ketis ◽  
Alenka Terbovc ◽  
Bostjan Gomiscek ◽  
Janko Kersnik
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Nurse Practitioners ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort

scholarly journals Relationship between cardiovascular risk and lipid testing in one health care system: a retrospective cohort study

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Robert J. Reid ◽  
Melissa L. Anderson ◽  
Paul A. Fishman ◽  
Jennifer B. McClure ◽  
Ron L. Johnson ◽  
...  
Keyword(s):  
Health Care ◽  
Cohort Study ◽  
Cardiovascular Risk ◽  
Health Care System ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
One Health ◽  
System A ◽  
Lipid Testing ◽  
Care System
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