20.500.12556/RUL-183201 Vpliv uporabe obposteljne ultrasonografije karotidnih arterij na adherenco pri jemanju proti-maščobnih zdravil raziskovalni podatki, obravnavani v članku Effect of use of carotid artery point-of-care ultrasonography on lipid lowering drug adherence research data underlying the article UVOD: Eden najpomembnejših izzivov v primarni srčno-žilni preventivi predstavlja slaba adherenca pri jemanju proti-maščobnih zdravil, ki ne presega 50%. Obposteljna ultrasonografija (OPUS) karotidnih arterij je nova metoda izvajana s strani družinskih zdravnikov, ki bi lahko dosegla preboj pri izboljšanju adherence v primarni srčno-žilni preventivi. Prisotnost aterosklerotičnih plakov na karotidnih arterijah je pomembna najdba, ki vpliva na odločitev o pričetku zdravljenja, prav tako pa (ob predstavitvi na zaslonu naprave) predstavlja pomemben dokaz (tako za pacienta, kot zdravnika) o pomembnosti zdravljenja. METODE: Izvedli smo randomizirano intervencijsko raziskavo v katero smo vključili 379 na videz zdravih preiskovancev z dejavniki srčno-žilnega tveganja iz desetih ambulant družinske medicine. Ugotavljali smo vpliv intervencije z OPUS karotidnih arterij na adherenco pri jemanju proti-maščobnih zdravil, katero smo merili s spremembo vrednosti LDL-holesterola v krvnem serumu v 9-mesečnem opazovanem obdobju. Dodatno smo ugotavljali prevalenco aterosklerotičnih plakov in računali specifičnost in občutljivost preiskave OPUS karotidnih arterij s ciljem prepoznave aterosklerotičnih plakov na karotidnih arterijah. Ugotavljali smo tudi kako prisotnost aterosklerotičnih plakov vpliva na intenzivnost terapije, ki jo zdravnik predpiše. REZULTATI: Prevalenca aterosklerotičnih plakov v populaciji na videz zdravih posameznikov z dejavniki srčno-žilnega tveganja starih med 40 in 69 let je bila 68,9% [63,8-73,6]. Ugotovili smo visoko občutljivost (96,6% [91,7-98,8]) in specifičnost (90,0% [79,5-96,2]) preiskave OPUS karotidnih arterij. Pri ugotavljanju adherence statistično pomembne razlike med kontrolno in intervencijsko skupino nismo dokazali (p=0,2), prav tako ne med skupino s plaki in brez njih (p=0,4). Prisotnost plakov je statistično pomembno (p<0,001) vplivala na intenzivnost terapije predpisane s strani družinskih zdravnikov. ZAKLJUČKI: OPUS karotidnih arterij je visoko specifična in občutljiva metoda za prepoznavanje karotidne ateroskleroze. Pri 7 od 10 preiskovancev smo ugotovili aterosklerotične plake na karotidnih arterijah. Metoda OPUS karotidnih arterij s predstavitvijo plakov na zaslonu naprave adherence pri jemanju proti-maščobnih zdravil ne izboljša, pomembno pa vpliva na intenzivnost terapije, ki jo zdravnik predpiše. INTRODUCTION: Poor adherence to lipid-lowering therapy remains one of the major challenges in primary cardiovascular prevention, with adherence rates rarely exceeding 50%. Point-of-care ultrasound (POCUS) of the carotid arteries, performed by family medicine physicians, represents a novel approach that may contribute to improving adherence in primary cardiovascular prevention. The presence of carotid atherosclerotic plaques is an important finding that influences treatment initiation decisions and, when visualized directly on the ultrasound screen, provides compelling evidence for both patients and physicians regarding the importance of preventive therapy. METHODS: We conducted a randomized interventional study involving 379 apparently healthy individuals with cardiovascular risk factors recruited from ten family medicine practices. The primary objective was to assess the effect of a carotid artery POCUS intervention on adherence to lipid-lowering therapy, measured by changes in serum low-density lipoprotein cholesterol levels during a 9-month follow-up period. Additionally, we determined the prevalence of carotid atherosclerotic plaques and evaluated the diagnostic performance of carotid artery POCUS for plaque detection by calculating its sensitivity and specificity. Furthermore, we investigated the influence of carotid plaque presence on the intensity of lipid-lowering therapy prescribed by family medicine physicians. RESULTS: The prevalence of carotid atherosclerotic plaques among apparently healthy individuals aged 40–69 years with cardiovascular risk factors was 68.9% (95% CI: 63.8–73.6). Carotid artery POCUS demonstrated high sensitivity (96.6%; 95% CI: 91.7–98.8) and specificity (90.0%; 95% CI: 79.5–96.2) for the detection of carotid atherosclerotic plaques. No statistically significant difference in adherence to lipid-lowering therapy was observed between the intervention and control groups (p = 0.20), nor between participants with and without carotid plaques (p = 0.40). However, the presence of carotid plaques had a statistically significant impact on the intensity of lipid-lowering therapy prescribed by family physicians (p < 0.001). CONCLUSIONS: Carotid artery POCUS is a highly sensitive and specific method for the detection of carotid atherosclerosis. Atherosclerotic plaques were identified in approximately seven out of ten apparently healthy individuals with cardiovascular risk factors. Although visualization of carotid plaques during carotid artery POCUS did not improve adherence to lipid-lowering therapy, it significantly influenced the intensity of treatment prescribed by family physicians. OPUS POCUS adherenca OPUS karotidnih arterij statini prevalenca občutljivost in specifičnost POCUS drug adherene carotid artery POCUS statins prevalence sensitivity and specificity true false false Slovenski jezik Angleški jezik Slovenija Junij 2023-januar 2025 Neznano 2026-06-08 08:56:10 2026-06-08 21:59:22 2026-06-09 04:11:40 0000-00-00 00:00:00 2026 0 0 0000-00-00 NiDoloceno NiDoloceno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 2027-06-08 OpusKarotid_DataExportFINAL.xlsx OpusKarotid_DataExportFINAL.xlsx 1 3AA07FAEAF3B92893C9C11825DF6B3BE 7d49a8d051b0ab7cf01fb3a37b0d0d8e959c9f55a3f311d673c4266fa0cb2b45 4f302ea1-6307-11f1-9b0d-0050569b8976 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=235076 Medicinska fakulteta Meritve in testi 0 0 0