שם הנושא
Cardiovascular Health
Use of high-potency statin therapy or LDL-cholesterol level less than or equal to 70 mg/dL in individuals after CABG and/or angioplasty (ages 35 years or older)
Individuals who had an LDL-cholesterol level lower than or equal to 70 mg/dl (numerator), among Individuals aged 35 years or older who had CABG surgery and/or angioplasty and had at least one cholesterol-level test (denominator)
Rational:
Atherosclerosis, which may lead to acute myocardial infraction and stroke, is a disease in which plaque builds up inside arteries, causing them to harden and narrow over time. One of the main causes for plaque accumulation has been shown to be high blood-cholesterol levels [1]. The current Israeli guidelines (March 2018) are in accordance with the 2013 ACC/AHA Guideline and set a target for LDL-cholesterol levels in individuals with an established coronary heart disease of 70 mg/dL or less, or a reduction of 50% in LDL values [2]. As the latter cannot be measured in the frame of QICH, it is replaced with the use of high-potency statin therapy.
Numerator:
Individuals in the denominator who *had an LDL-cholesterol level lower than or equal to 70 mg/dl OR *had purchased at least three prescriptions of high-potency statins in the previous year, and their last LDL-cholesterol level was lower than or equal to 100 mg/dL
Denominator
Individuals aged 35 years or older who had CABG (coronary artery bypass) surgery and/or angioplasty in the ten previous years and had at least one cholesterol-level test in the measurement year
Notes:
None
References:
[1] Silverman MG et al., Association Between Lowering LDL-C and Cardiovascular Risk Reduction Among Different Therapeutic Interventions: A Systematic Review and Meta-analysis. JAMA. 2016 Sep 27;316(12):1289-97. doi: 10.1001/jama.2016.13985.
[2] In Hebrew: מקור: עדכון ההנחיות לטיפול בהיפרליפידמיה 2014 - עיקרי ההמלצות. החברה לחקר, מניעה וטיפול בטרשת העורקים, האיגוד לקרדיולוגיה בישראל, האיגוד הישראלי לרפואה פנימית, איגוד רופאי המשפחה, החברה הישראלית ליתר לחץ דם, האגודה הישראלית לסוכרת, האיגוד לנירולוגיה בישראל, העמותה הרפואית למניעה ולגמילה מעישון בישראל, והחברה הישראלית לתזונה קלינית
Results:
Use of high- potency statin therapy by year
Use of high- potency statin therapy by socio-economic position (1-lowest, 4-highest) and sex
