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Clinical Trial
. 2013 Dec;163(23-24):528-35.
doi: 10.1007/s10354-013-0219-z. Epub 2013 Aug 27.

Are There Differences in LDL-C Target Value Attainment in Austrian Federal States? Yes!

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Free PMC article
Clinical Trial

Are There Differences in LDL-C Target Value Attainment in Austrian Federal States? Yes!

Max Pichler et al. Wien Med Wochenschr. .
Free PMC article

Abstract

Low density lipoprotein (LDL-C) levels determine the cardiovascular risk. Previous studies indicated an LDL-C target attainment of around 50%, but no Austrian wide analysis on results for the federal states was available. We therefore sought to detect potential differences.

Design: Open-label, non-interventional, longitudinal study, registered: www.clinicaltrials.gov NCT 01381679. In all, 746 statin treated patients not at LDL-C goal received intensified therapy for 12 months. The sample was split into nine subgroups, representing the federal states of Austria.We detected an east-west gradient for baseline LDL-C. Individual target values were achieved by 37.2% (range: 26.1-57.7%). After 12 months, LDL-C < 70 mg/l was achieved by 13.5% (5.9-38.5%). Univariate ANCOVA retrieved significant differences within the states (Upper Austria and Salzburg, p = 0.001 and p = 0.0015, respectively). Furthermore, the capacity of intensified lipid lowering therapy applied in practice was as high as -42% as compared to previous standard therapy (additional LDL-C reduction after switch from baseline therapy in Vorarlberg).

Low Density Lipoprotein Cholesterin (LDL-C) Spiegel determinieren das kardiovaskuläre Risiko. Vorangegangene Studien zeigten eine LDL-C Zielwerterreichung von circa 50 %. Nachdem keine österreichweite geographische Analyse zur Zielwerterreichung verfügbar war, ermittelten wir, ob es Unterschiede zwischen den Österreichischen Bundesländern gibt. Design: Open-label, nicht-interventionelle, longitudinale Studie, registriert unter www.clinicaltrials.gov NCT01381679. 746 statinbehandelte Patienten, die ihren LDL-C Zielwert nicht erreichten, erhielten intensivierte Therapie. Die Stichprobe wurde in neun, die Österreichischen Bundesländer repräsentierenden, Subgruppen unterteilt. Ein Ost-West Gradient konnte für LDL-C zu Beginn der Studie festgestellt werden. LDL-C Werte < 70 mg/dl wurden von 13,5 % (5,9–38,5 %) der Patienten in Österreich nach 12 Monaten erreicht. Univariate ANCOVA zeigte einen signifikanten Unterschied zwischen den Bundesländern (Oberösterreich und Salzburg, p = 0,001, bzw. p = 0,0015). Die Kapazität intensivierter, in der Praxis angewandter, lipidsenkender Therapie betrug −42 % im Vergleich zu vorhergehender Standardtherapie (zusätzliche LDL-C Senkung nach Switch von der Therapie zu Beginn der Studie in Vorarlberg).

Trial registration: ClinicalTrials.gov NCT01381679.

Figures

Fig. 1
Fig. 1
Attainment of low density lipoprotein cholesterol values <70 mg/dl (current target value as set by the major European societies) after 12 months
Fig. 2
Fig. 2
Low density lipoprotein cholesterol levels at baseline of the study (mg/dl), illustrating the described east west gradient in Austria

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