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    Patient characteristics and statin discontinuation-related factors during treatment of hypercholesterolemia: an observational non-interventional study in patients with statin discontinuation (STAY study)
    (2016) Tokgözoğlu, Lale; Özdemir, Ramazan; Ceyhan, Ceyhun; Yeter, Ekrem; Öztürk, Cihan; Bayram, Fahri; Delibaşı, Tuncay; Değertekin, Muzaffer; Keleş, İbrahim; Dinçkal, Mustafa Hakan; Fak, Ali Serdar; Aydoğdu, Sinan; Zorkun, Cafer; Tartan, Zeynep
    Abstract: Amaç: Hiperkolesterolemi tanısı ile izlenen statin kullanmakta olan hastalarda statin tedavisinin kesilmesi ile ilişkili hasta özellikleri ve sorumlu faktörlerin belirlenmesi.Yöntemler: Bu ulusal müdahalesiz gözlem çalışmasına statin tedavisini bırakmış toplam 532 (ort. yaş±SS 57.4±11.5 yıl; %52.4 kadın, %47.6 erkek) hiperkolesterolemili hasta dahil edildi. Hastaların sosyodemografik özellikleri kardiyovasküler risk faktörleri, geçmiş statin tedavisi ve tedavinin kesilmesine yönelik veriler tek vizitte kaydedildi.Bulgular: Hastalara statin tedavisini bıraktıklarında ort.±SS 4.9±4.2 yıldı, hiperkolesterolemi tanısı konulmuş olduğu tespit edildi. Statin tedavisi hekim grupları içinde en sık kardiyologlar (%55.8) tarafından başlatılırken, tedaviyi bırakma kararının büyük çoğunlukla hastalar (%73.7) tarafından alındığı; hastanın bu kararı kendi insiyatifinde almasının daha yüksek eğitim düzeylerinde (%80.4), düşük eğitim düzeylerine (%69.7) göre belirgin olarak daha yaygın (p=0.022) olduğu saptandı. TV programlarında statin hakkında yapılan olumsuz haberler (%32.9); ilacın hepatik (%38.0), renal (%33.8) ve musküler (%32.9) yan etkilerinden çekinilmesi statin tedavisinin bırakılması ile ilişkili en sık oranda saptanan faktörler idi.Sonuç: Sonuç olarak, bu müdahalesiz gözlemsel çalışmada, statin tedavisinin %74 oranda hastaların kendi kendine ilacı bırakma kararı doğrultusunda gerçekleştiği saptanmıştır. Tedavi bırakma ve ilaç dışı alternatif tedavilere yönelme kararının daha yüksek eğitim düzeyine sahip hastalarca daha sıklıkla alındığı görülmüştür. Statin tedavisinin en sık kardiyologlar tarafından başlatıldığı ve TV programlarında statin hakkında özellikle ilacın yaşamı tehdit etmeyen yan etkilerine yönelik yapılan olumsuz haberlerin yanı sıra, hastaların hiperkolesterolemi ve ilgili riskleri konusunda yeterli bilgi düzeyinden yoksun olmalarının statin tedavisinin bırakılmasında öne çıkan sorumlu faktörler olduğu anlaşılmaktadır
  • Küçük Resim Yok
    Öğe
    Patient characteristics and statin discontinuation-related factors during treatment of hypercholesterolemia: an observational non-interventional study in patients with statin discontinuation (STAY study)
    (Turkish Soc Cardiology, 2016) Tokgozoglu, Lale; Ozdemir, Ramazan; Altindag, Rojhat; Ceyhan, Ceyhun; Yeter, Ekrem; Ozturk, Cihan; Bayram, Fahri
    Objective: The purpose of this study was to identify patient characteristics and statin discontinuation-related factors in patients with hypercholesterolemia. Methods: A total of 532 patients (age mean+/-SD: 57.4+/-11.5 years; 52.4% women, 47.6% men) with hypercholesterolemia and statin discontinuation were included in this national cross-sectional noninterventional observational study. Data on socio-demographic characteristics of patients, cardiovascular risk factors, past treatment with and discontinuation of statin treatment were collected in one visit. Results: Mean+/-SD duration of hypercholesterolemia was 4.9+/-4.2 years at time of discontinuation of statin treatment. Statin treatment was initiated by cardiologists in the majority of cases (55.8%), whereas discontinuation of statin treatment was decided by patients in the majority of cases (73.7%), with patients with higher (at least secondary education, 80.4%) more likely than those with lower (only primary education, 69.7%) to decide to discontinue treatment (p=0.022). Negative information about statin treatment disseminated by TV programs-mostly regarding coverage of hepatic (38.0%), renal (33.8%), and muscular (32.9%) side effects (32.9%)-was the most common reason for treatment discontinuation. Conclusion: The decision to discontinue statin treatment was made at the patient's discretion in 74% of cases, with higher likelihood of patients with higher educational status deciding to discontinue treatment and switch to non-drug lipid-lowering alternatives. Cardiologists were the physicians most frequently responsible for the initiation of the statin treatment; coverage of several non-lifethreatening statin side effects by TV programs and patients' lack of information regarding high cholesterol and related risks were the leading factors predisposing to treatment discontinuation.
  • Küçük Resim Yok
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    What have we learned from Turkish familial hypercholesterolemia registries (A-HIT1 and A-HIT2)?
    (Elsevier Ireland Ltd, 2018) Kayikcioglu, Meral; Tokgozoglu, Lale; Dogan, Volkan; Ceyhan, Ceyhun; Tuncez, Abdullah; Kutlu, Merih; Onrat, Ersel
    Background and aims: Familial hypercholesterolemia (FH) is a common genetic disease of high-level cholesterol leading to premature atherosclerosis. One of the key aspects to overcome FH burden is the generation of largescale reliable data in terms of registries. This manuscript underlines the important results of nation-wide Turkish FH registries (A-HIT1 and A-HIT2). Methods: A-HIT1 is a survey of homozygous FH patients undergoing low density lipoprotein (LDL) apheresis (LA). A-HIT2 is a registry of adult FH patients (homozygous and heterozygous) admitted to outpatient clinics. Both registries used clinical diagnosis of FH. Results: A-HIT1 evaluated 88 patients (27 +/- 11 years, 41 women) in 19 centers. All patients were receiving regular LA. There was a 7.37 +/- 7.1-year delay between diagnosis and initiation of LA. LDL-cholesterol levels reached the target only in 5 cases. Mean frequency of apheresis sessions was 19 +/- 13 days. None of the centers had a standardized approach for LA. Mean frequency of apheresis sessions was every 19 +/- 13 (7-90) days. Only 2 centers were aware of the target LDL levels. A-HIT2 enrolled 1071 FH patients (53 +/- 8 years, 606 women) from 31 outpatients clinics specialized in cardiology (27), internal medicine (1), and endocrinology (3); 96.4% were heterozygous. 459 patients were on statin treatment. LDL targets were attained in 23 patients (2.1% of the whole population, 5% receiving statin) on treatment. However, 66% of statin-receiving patients were on intense doses of statins. Awareness of FH was 9.5% in the whole patient population. Conclusions: The first nationwide FH registries revealed that FH is still undertreated even in specialized centers in Turkey. Additional effective treatment regiments are urgently needed.