[Primary and secondary prevention in hypercholesterolemia: differences relevant to patient care in the PROCYON trial].

Abstract

BACKGROUND:

Cardiovascular disease accounts for one third of deaths in Germany. Elevated levels of low-density lipoprotein cholesterol (LDL-C) are considered a major risk factor. Lowering LDL-C levels is therefore an integral part of the prevention of cardiovascular events.

METHODS:

The aim of this work is to identify potential differences between primary prevention (PP) and secondary prevention (SP) by means of a post-hoc comparison of cross-sectional data from the PROCYON survey. Medical history, concomitant diseases, adherence, and disease awareness in relation to hypercholesterolemia were queried.

RESULTS:

5,494 patients had participated in the survey (PP: 3,798; SP: 1,696). Comparison of the results showed a numerically higher proportion of women (PP 70.7% vs. SP 42.5%) as well as more frequent comorbidities such as hypertension (PP 45.6% vs. SP 61.0%), obesity (PP 20.9% vs. SP 27.4%), and type 2 diabetes mellitus (PP 14.1% vs. SP 23.8%). In primary prevention, hypercholesterolemia was most often diagnosed during screening (PP 74.6%), and in secondary prevention, the diagnosis was most often made during cardiovascular-related hospitalization (SP 58.0%). A cardiologist was consulted by 16.3% (PP) and 54.0% (SP) of patients, respectively. At least semiannual LDL-C checks (PP 46.8% vs. SP 77.9%) and drug intervention (PP 43.0% vs. SP 87.0%) were more frequent in the secondary prevention group. In addition, differences in the implementation of lifestyle changes, improvement of LDL-C levels, adjustment of therapy as well as adherence, treatment satisfaction and patient knowledge were observed.

CONCLUSION:

The comparison of primary and secondary prevention from the PROCYON survey shows overall better utilization of treatment options and higher intensity of care in the secondary prevention group. However, there is still great potential for improvement in both groups to ensure efficient prevention of cardiovascular events.

• Authors: Umidakhon Makhmudova, Michaela Wolf, Kathy Willfeld, Lea Beier, Oliver Weingärtner
• Journal: Deutsche medizinische Wochenschrift (1946) (Dtsch Med Wochenschr) Vol. 148 Issue 19 Pg. e101-e110 (09 2023) ISSN: 1439-4413 [Electronic] Germany
• Vernacular Title: Primär- und Sekundärprävention bei Hypercholesterinämie – versorgungsrelevante Unterschiede in der PROCYON-Studie.
• PMID: 37604168 (Publication Type: English Abstract, Journal Article)
• Copyright: The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Chemical References

• Cholesterol, LDL

Topics

• Humans
• Female
• Animals
• Hypercholesterolemia (therapy)
• Raccoons
• Secondary Prevention
• Cholesterol, LDL
• Cross-Sectional Studies
• Diabetes Mellitus, Type 2
• Patient Care
• Cardiovascular Diseases (epidemiology, prevention & control)