Evaluacija terapije hipolipemicima u pacijenata s kardiovaskularnim bolestima

master's thesis

• Title (english): Evaluation of lipid-lowering therapy in patients with cardiovascular diseases
• Author: Anamaria Ukić
• Mentor: Ivana Marinović (mentor)
• Mentor: Ivana Samardžić (sumentor)
• Committee member: Ivana Marinović (predsjednik povjerenstva)
• Committee member: Ivana Samardžić (član povjerenstva)
• Committee member: Maja Friščić (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Centre for applied pharmacy); Zagreb
• Defense date and country: 2024-07-19, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

Kardiovaskularne bolesti predstavljaju glavni uzrok morbiditeta i mortaliteta u RepubliciHrvatskoj, kao i širom svijeta. Ključnu ulogu u patogenezi kardiovaskularnih bolesti ima ateroskleroza koja nastaje kao posljedica visokih razina kolesterola u krvi. Dokazana je direktna povezanost redukcije LDL kolesterola sa smanjenjem kardiovaskularnih događaja. Pacijenti se prema desetogodišnjem riziku od smrtnih i ostalih kardiovaskularnog rizika svrstavaju u četiri skupine: nizak, umjereni, visoki i vrlo visoki kardiovaskularni rizik. Ovisno o razini kardiovaskularnog rizika određene su ciljne vrijednosti LDL kolesterola koje se postižu različitim hipolipemicima. U Republici Hrvatskoj dostupni su različiti lijekovi za sniženje lipida u serumu, uključujući statine, fibrate, PCSK-9 inhibitore i inklisiran. U ovo istraživanje uključeno je 88 ispitanika koji su zaprimljeni na Zavod za bolesti srca i krvnih žila Kliničke bolnice Dubrava u Zagrebu. Temeljni cilj istraživanja bio je analizirati farmakoterapiju hipolipemicima kod kardioloških pacijenata pri prijemu u bolnicu primjenom NMMP (Najbolja moguća medikacijska povijest). Isto tako, cilj je bio utvrditi učestalost interakcija hipolipemika s ostalim lijekovima koji pacijenti imaju u terapiji. Vrijednosti LDL kolesterola pri prijemu pacijenata bilježeni su putem BIS-a (Bolnički informacijski sustav), dok je za utvrđivanje stupnja klinički značajnih interakcija korišten program Lexicomp®. Od uključenih ispitanika, 93,18% je svrstano u kategoriju vrlo visokog rizika. U ovom istraživanju, 23,86% pacijenata zaprimljena u bolnicu imala su zadovoljavajuće LDL vrijednosti. Od toga, 21,95% pacijenata vrlo visokog rizika imalo je zadovoljavajući LDL pri prijemu, dok je 50% pacijenata umjerenog rizika imala ciljne vrijednosti LDL-a. Velik udio pacijenata imalo je propisanu politerapiju i prekomjernu politerapiju. Osim odabira odgovarajućeg hipolipemika, važno je razmotriti i potencijalne interakcije hipolipemika s drugim lijekovima. U potencijalnim klinički značajnim interakcijama lijekova najčešće su bili uključeni statini. Atorvastatin je bio najčešće utvrđeni hipolipemik u potencijalnim klinički značajnim interakcijama. Kako bi se poboljšala kontrola LDL- a, na prijemu u bolnicu osobito je važno utvrditi bolesnike s visokim/vrlo visokim kardiovaskularnim rizikom.

Abstract (english)

Cardiovascular diseases are the leading cause of morbidity and mortality in the Republic of Croatia and worldwide. Atherosclerosis, caused by high levels of cholesterol in the blood, plays a crucial role in the pathogenesis of these diseases. There is a proven direct correlation between reducing LDL cholesterol and decreasing cardiovascular events. Patients are classified into four groups based on their ten-year risk of fatal and other cardiovascular events: low, medium, high and very high cardiovascular risk. Depending on the level of cardiovascular risk, target LDL cholesterol values are determined and achieved through the use of various hypolipemic agents. In the Republic of Croatia, various lipid-lowering drugs are accessible, such as statins, fibrates, PCSK-9 inhibitors, and others. This study involved 88 participants admitted to the Department of Cardiovascular Diseases at Dubrava Clinic Hospital in Zagreb. The primary aim of the study was to gain insight into the hypolipemic therapy of cardiology patients upon hospital admission using the Best Possible Medication History (BMPH). Another goal was to assess the frequency of interactions between hypolipemic drugs and other medications in the patient's therapy. LDL cholesterol levels at patient admission were documented using the Hospital Information System while the Lexicomp® program was utilized to assess the extent of clinically significant interactions. In total 93.18% patients were classified as patients with very high cardiovascular risk. In this study, 23.86% of patients admitted to the hospital had recommneded LDL values. Of these, 21.95% of very high-risk patients had recommended LDL at admission, while 50% of moderate-risk patients had LDL target values. A large proportion of patients had prescribed polytherapy and excessive polytherapy. In order to optimize pharmacitherapy, it is important to consider the potential interactions of the hypolipemic agents with other drugs. Statins were most often involved in potential clinically significant drug-drug interactions. Atorvastatin was the most frequently identified hypolipemic drug in potential clinically significant drug-drug interactions. In order to improve LDL control, it is particularly important to identify patients with high/very high cardiovascular risk at hospital admission.

• Keywords: kardiovaskularne bolesti; kardiovaskularni lijekovi; kardiovaskularni rizik; hipolipemici; statini; NMMP; LDL kolesterol
• Keywords (english): cardiovascular diseases; cardiovascular drugs; cardiovascular risk; hypolipemic agents; statins; NMMP; LDL cholesterol
• Language: croatian
• URN:NBN: urn:nbn:hr:163:448707
• Study programme: Title: Pharmacy - integrated undergraduate and graduate - university study; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: sveučilišni magistar farmacije (sveučilišni magistar farmacije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-09-26 12:25:26