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Research Article
8 March 2023

Evaluation of hypercholesterolemia management in at-risk patients by cardiologists in France: a case vignette-based study

Authors: Jean Ferrières https://orcid.org/0000-0001-6144-1297 [email protected], Eric Bruckert https://orcid.org/0000-0002-4527-9629, Michel Farnier https://orcid.org/0000-0002-0349-7978, Michel Krempf https://orcid.org/0000-0002-4353-9511, Jean-Jacques Mourad https://orcid.org/0000-0003-0877-8311, Baptiste Roux, and François Schiele https://orcid.org/0000-0003-4974-6551Author Info & Affiliations
Volume 12, Number 4
https://doi.org/10.57264/cer-2022-0181
PDFFormats

Abstract

Aim: This online interactive survey investigated lipid-lowering approaches of French cardiologists in high- and very high-cardiovascular risk patients with hypercholesterolemia. Materials & methods: Physicians assessed three hypothetical patients at three clinic visits, and selected the patients’ cardiovascular risk category, target low-density lipoprotein cholesterol (LDL-C) and treatment. Results: A total of 162 physicians completed 480 risk assessments; 58% of assessments correctly categorized the hypothetical patients. Most physicians chose the correct LDL-C target for one of the very high-risk patients, but higher-than-recommended targets were selected for the other very high-risk patient and the high-risk patient. Statins were the most commonly chosen treatment. Conclusion: French cardiologists often underestimate cardiovascular risk in patients with hypercholesterolemia, select a higher-than-recommended LDL-C target and prescribe less intensive treatment than that recommended by guidelines.

Tweetable abstract

Based on case vignette analysis, French cardiologists underestimate cardiovascular risk in patients with hypercholesterolemia, resulting in suboptimal treatment #hypercholesterolemia #LDL-C target #lipid-lowering therapy

Graphical abstract

Plain language summary

What is this article about?

Cardiovascular disease is the main cause of death in Europe. High blood cholesterol (or hypercholesterolemia) is one of the major risk factors for cardiovascular disease, but it can be controlled by proper treatment. Studies have shown that patients in France with hypercholesterolemia generally receive suboptimal treatment.

What were the results?

We surveyed 162 French cardiologists to understand their approach to lowering of low-density lipoprotein cholesterol (LDL-C) levels. Using an online interactive survey, the physicians communicated with three virtual patients presenting hypothetical clinical scenarios. We found that many of the French cardiologists incorrectly judged the cardiovascular risk in patients with hypercholesterolemia, lacked knowledge about the correct LDL-C targets, and prescribed less intensive treatment than that recommended by guidelines.

What do the results of the study mean?

In order to decrease the proportion of patients receiving suboptimal treatment, continued physician education in assessing cardiovascular risk and increasing familiarity with correct LDL-C targets are required.

Supplementary Material

File (supplementary material.docx)

References

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