Амбулаторная гиполипидемическая терапия у пациентов с очень высоким сердечно-сосудистым риском в период пандемии COVID-19

Abstract

Background: despite a broad armamentarium of effective lipid-lowering agents, which is being replenished by new classes of drugs, the achievement of target lipid metabolism (LM) parameters in patients at high and very high cardiovascular risk (CVR) remains extremely urgent. The accumulation of data on SARS-CoV-2 during the pandemic contributed to a detailed study of the pathogenetic mechanisms of COVID-19. Among these mechanisms, endothelial dysfunction and atherosclerosis are the most important. Therefore, there is concern about LM in patients with cardiovascular disorders who have experienced coronavirus disease 2019, when adequate lipid-lowering therapy (LLT) determines further prognosis and survival Aim: to evaluate outpatient LLT in patients with very high CVR during the COVID-19 pandemic. Patients and Methods: 114 patients with cardiovascular disorders and very high CVR underwent a voluntary direct clinical interview about LLT and laboratory tests for LM during the COVID-19 pandemic. Results: low awareness of atherosclerosis and the importance of LLT was reported (only 26.32% of patients could be described as fully aware). Most patients (48.24%) only learn about their LM status after admission to hospital. 41.23% monitor their lipid profile on an outpatient basis every 3–6 months, but only 25.44% were able to specify their serum cholesterol level. Study participants received statins as LLT during the COVID-19 pandemic, but 48.94% received statins at inappropriately low doses. COVID-19 morbidity affected adherence to LLT, i.e. 38.59% discontinued lipid-lowering therapy during COVID-19 and 17.54% never restarted it after recovery. Evaluation of laboratory tests for LM in patients with very high CVR showed that only 6.26% achieved target values. Conclusion: low awareness, unhealthy lifestyle and inadequate drug therapy during the COVID-19 pandemic worsen LM and prognosis in patients with very high CVR in terms of adverse cardiovascular events. KEYWORDS: lipid-lowering therapy, dyslipidemia, lipid metabolism, cardiovascular risk, COVID-19 pandemic, adherence. FOR CITATION: Sergeeva V.A., Lipatova T.E. Outpatient lipid-lowering therapy in patients at very high cardiovascular risk during the COVID-19 pandemic. Russian Medical Inquiry. 2024;8(1):9–15 (in Russ.). DOI: 10.32364/2587-6821-2024-8-1-2.