Original article
Have the Government's prescription algorithm and the 2013 American College of Cardiology/American Heart Association guidelines for managing dyslipidemia influenced the management of dyslipidemia? The MEJORALO-CV Project
¿Han influido el algoritmo de prescripción de la Administración y las guías de manejo de la dislipemia de la ACC/AHA 2013 en el manejo de la dislipemia? Proyecto MEJORALO-CV
V. Giner Galvaña,b,
, I. Bonig Triguerosc, L. Fácila Rubiod, P. Morillas Blascoe, S. Martínez Hervásf, V. Pascual Fusterg, F. Valls Rocah, C. Soler Portmanna,b, J.J. Tamarit Garcíai, V. Pallarés Carrataláj,k, MEJORA-LO CV Working Group ◊
Corresponding author
a Unidad de HTA y Riesgo Cardiometabólico, Servicio de Medicina Interna, Hospital Clínico Universitario de San Juan, San Juan de Alicante, Alicante, Spain
b Departamento de Medicina Clínica, Facultad de Medicina, Universidad Miguel Hernández, Elche, Alicante, Spain
c Servicio de Medicina Interna, Hospital de La Plana, Villarreal (Castellón), Spain
d Servicio de Cardiología, Hospital General Universitario de Valencia, Valencia, Spain
e Servicio de Cardiología, Hospital General Universitario de Elche, Elche (Alicante), Spain
f Servicio de Endocrinología, Hospital Clínico Universitario de Valencia, Valencia, Spain
g Centro de Salud Palleter, Castellón, Spain
h Centro de Salud de Benigànim, Benigànim (Valencia), Spain
i Servicio de Medicina Interna, Hospital General Universitario, Valencia, Spain
j Unión de Mutuas, Castellón, Spain
k Departamento de Medicina, Universitat Jaume I, Castellón, Spain
Ver másMembers of the MEJORALO-CV workgroup , José María Cepeda Rodrigoaa, Juan Cosín Salesab, Rafael Durá Belinchónac, Enrique Gómez Segadoad, Saray Monleón Arenósae, Carlos Morillas Ariñoaf, Enrique Rodilla Salaag, Eduardo Rovira Daudíah, David Vicente Navarroai
aa Department of Internal Medicine, Hospital de la Vega Baja, Orihuela (Alicante), Spain
ab Department of Cardiology, Hospital Arnau de Vilanova, Valencia, Spain
ac Health Center of Godella, Godella (Valencia), Spain
ad Department of Internal Medicine, Hospital de la Marina Baja, Villajoyosa (Alicante), Spain
ae Health Center of Vinaroz, Vinaroz, Castellón, Spain
af Department of Endocrinology, University Hospital Doctor Peset, Valencia, Spain
ag Arterial Hypertension Unit, Department of Internal Medicine, Hospital of Sagunto, Sagunto (Valencia), Spain
ah Department of Internal Medicine, University Hospital La Ribera, Alzira (Valencia), Spain
ai Department of Internal Medicine, Hospital of Vinalopó, Elche (Alicante), Spain
Ver másRead
17
Timeswas read the article
3
Total PDF
14
Total HTML
Share statistics
array:25 [ "pii" => "S2254887419302279" "issn" => "22548874" "doi" => "10.1016/j.rceng.2019.08.006" "estado" => "S300" "fechaPublicacion" => "2020-06-01" "aid" => "1737" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)" "copyrightAnyo" => "2019" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Clin Esp. 2020;220:282-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S001425651930236X" "issn" => "00142565" "doi" => "10.1016/j.rce.2019.08.006" "estado" => "S300" "fechaPublicacion" => "2020-06-01" "aid" => "1737" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Clin Esp. 2020;220:282-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 4 "formatos" => array:2 [ "HTML" => 2 "PDF" => 2 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original</span>" "titulo" => "¿Han influido el algoritmo de prescripción de la Administración y las guías de manejo de la dislipemia de la ACC/AHA 2013 en el manejo de la dislipemia? Proyecto MEJORA-LO CV" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "282" "paginaFinal" => "289" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Have the Government's prescription algorithm and the 2013 American College of Cardiology/American Heart Association guidelines for managing dyslipidaemia influenced the management of dyslipidaemia? The MEJORALO-CV Project" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1506 "Ancho" => 1504 "Tamanyo" => 88981 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Determinantes de la ausencia de control lipídico según los encuestados expresado como prevalencia (% referido al total de respuestas dadas).</p>" ] ] ] "autores" => array:2 [ 0 => array:2 [ "autoresLista" => "V. Giner Galvañ, I. Bonig Trigueros, L. Fácila Rubio, P. Morillas Blasco, S. Martínez Hervás, V. Pascual Fuster, F. Valls Roca, C. Soler Portmann, J.J. Tamarit García, V. Pallarés Carratalá" "autores" => array:11 [ 0 => array:2 [ "nombre" => "V." "apellidos" => "Giner Galvañ" ] 1 => array:2 [ "nombre" => "I." "apellidos" => "Bonig Trigueros" ] 2 => array:2 [ "nombre" => "L." "apellidos" => "Fácila Rubio" ] 3 => array:2 [ "nombre" => "P." "apellidos" => "Morillas Blasco" ] 4 => array:2 [ "nombre" => "S." "apellidos" => "Martínez Hervás" ] 5 => array:2 [ "nombre" => "V." "apellidos" => "Pascual Fuster" ] 6 => array:2 [ "nombre" => "F." "apellidos" => "Valls Roca" ] 7 => array:2 [ "nombre" => "C." "apellidos" => "Soler Portmann" ] 8 => array:2 [ "nombre" => "J.J." "apellidos" => "Tamarit García" ] 9 => array:2 [ "nombre" => "V." "apellidos" => "Pallarés Carratalá" ] 10 => array:1 [ "colaborador" => "en representación del Grupo de Trabajo MEJORA-LO CV" ] ] ] 1 => array:2 [ "autoresLista" => "" "autores" => array:1 [ 0 => array:1 [ "colaborador" => "Componentes del grupo de Trabajo MEJORALO-CV" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2254887419302279" "doi" => "10.1016/j.rceng.2019.08.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887419302279?idApp=WRCEE" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S001425651930236X?idApp=WRCEE" "url" => "/00142565/0000022000000005/v2_202006060645/S001425651930236X/v2_202006060645/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S225488742030028X" "issn" => "22548874" "doi" => "10.1016/j.rceng.2019.10.009" "estado" => "S300" "fechaPublicacion" => "2020-06-01" "aid" => "1760" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "edi" "cita" => "Rev Clin Esp. 2020;220:290-1" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "titulo" => "COPD and cardiovascular disease: more than just a co-incidence" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "290" "paginaFinal" => "291" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "EPOC y enfermedad cardiovascular: algo más que una co-incidencia" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "X. Pena, C. Guijarro" "autores" => array:2 [ 0 => array:2 [ "nombre" => "X." "apellidos" => "Pena" ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Guijarro" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0014256519302875" "doi" => "10.1016/j.rce.2019.10.007" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256519302875?idApp=WRCEE" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S225488742030028X?idApp=WRCEE" "url" => "/22548874/0000022000000005/v1_202006100751/S225488742030028X/v1_202006100751/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2254887419302310" "issn" => "22548874" "doi" => "10.1016/j.rceng.2019.09.005" "estado" => "S300" "fechaPublicacion" => "2020-06-01" "aid" => "1733" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Clin Esp. 2020;220:275-81" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 3 "formatos" => array:2 [ "HTML" => 1 "PDF" => 2 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Hemodynamic profile of Spanish adults with Down syndrome" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "275" "paginaFinal" => "281" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Perfil hemodinámico de los adultos españoles con síndrome de Down" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1120 "Ancho" => 2249 "Tamanyo" => 99116 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0035" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Hemodynamic state of adults with Down syndrome and its modulators (print in color).</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Abscissa axis: hemodynamic state and its modulators; ordinate axis: percentage of patients in each category.</p> <p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Red, hyper; green, normal; blue, hypo.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "E. Roy-Vallejo, E. Alonso, J.M. Galván-Román, P. Ibañez, F. Moldenhauer, C. Suárez Fernández, D. Real de Asúa" "autores" => array:7 [ 0 => array:2 [ "nombre" => "E." "apellidos" => "Roy-Vallejo" ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Alonso" ] 2 => array:2 [ "nombre" => "J.M." "apellidos" => "Galván-Román" ] 3 => array:2 [ "nombre" => "P." "apellidos" => "Ibañez" ] 4 => array:2 [ "nombre" => "F." "apellidos" => "Moldenhauer" ] 5 => array:2 [ "nombre" => "C." "apellidos" => "Suárez Fernández" ] 6 => array:2 [ "nombre" => "D." "apellidos" => "Real de Asúa" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0014256519302322" "doi" => "10.1016/j.rce.2019.09.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256519302322?idApp=WRCEE" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887419302310?idApp=WRCEE" "url" => "/22548874/0000022000000005/v1_202006100751/S2254887419302310/v1_202006100751/en/main.assets" ] "asociados" => array:1 [ 0 => array:19 [ "pii" => "S2254887420300461" "issn" => "22548874" "doi" => "10.1016/j.rceng.2020.02.001" "estado" => "S300" "fechaPublicacion" => "2020-06-01" "aid" => "1816" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "edi" "cita" => "Rev Clin Esp. 2020;220:294-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "titulo" => "Cardiovascular prevention guidelines of the scientific societies and healthcare administrations: The need for convergence" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "294" "paginaFinal" => "296" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Guías de prevención cardiovascular de sociedades científicas y administraciones sanitarias: la necesidad de convergencia" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Ruiz García, C. Guijarro Herráiz" "autores" => array:2 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Ruiz García" ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Guijarro Herráiz" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S001425652030093X" "doi" => "10.1016/j.rce.2020.02.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S001425652030093X?idApp=WRCEE" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887420300461?idApp=WRCEE" "url" => "/22548874/0000022000000005/v1_202006100751/S2254887420300461/v1_202006100751/en/main.assets" ] ] "en" => array:22 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Have the Government's prescription algorithm and the 2013 American College of Cardiology/American Heart Association guidelines for managing dyslipidemia influenced the management of dyslipidemia? The MEJORALO-CV Project" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "282" "paginaFinal" => "289" ] ] "autores" => array:2 [ 0 => array:4 [ "autoresLista" => "V. Giner Galvañ, I. Bonig Trigueros, L. Fácila Rubio, P. Morillas Blasco, S. Martínez Hervás, V. Pascual Fuster, F. Valls Roca, C. Soler Portmann, J.J. Tamarit García, V. Pallarés Carratalá" "autores" => array:11 [ 0 => array:4 [ "nombre" => "V." "apellidos" => "Giner Galvañ" "email" => array:1 [ 0 => "giner_vicgal@gva.es" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "I." "apellidos" => "Bonig Trigueros" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 2 => array:3 [ "nombre" => "L." "apellidos" => "Fácila Rubio" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 3 => array:3 [ "nombre" => "P." "apellidos" => "Morillas Blasco" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] ] ] 4 => array:3 [ "nombre" => "S." "apellidos" => "Martínez Hervás" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">f</span>" "identificador" => "aff0030" ] ] ] 5 => array:3 [ "nombre" => "V." "apellidos" => "Pascual Fuster" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">g</span>" "identificador" => "aff0035" ] ] ] 6 => array:3 [ "nombre" => "F." "apellidos" => "Valls Roca" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">h</span>" "identificador" => "aff0040" ] ] ] 7 => array:3 [ "nombre" => "C." "apellidos" => "Soler Portmann" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 8 => array:3 [ "nombre" => "J.J." "apellidos" => "Tamarit García" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">i</span>" "identificador" => "aff0045" ] ] ] 9 => array:3 [ "nombre" => "V." "apellidos" => "Pallarés Carratalá" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">j</span>" "identificador" => "aff0050" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">k</span>" "identificador" => "aff0055" ] ] ] 10 => array:2 [ "colaborador" => "MEJORA-LO CV Working Group" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">◊</span>" "identificador" => "fn0005" ] ] ] ] "afiliaciones" => array:11 [ 0 => array:3 [ "entidad" => "Unidad de HTA y Riesgo Cardiometabólico, Servicio de Medicina Interna, Hospital Clínico Universitario de San Juan, San Juan de Alicante, Alicante, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Departamento de Medicina Clínica, Facultad de Medicina, Universidad Miguel Hernández, Elche, Alicante, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital de La Plana, Villarreal (Castellón), Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Servicio de Cardiología, Hospital General Universitario de Valencia, Valencia, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Servicio de Cardiología, Hospital General Universitario de Elche, Elche (Alicante), Spain" "etiqueta" => "e" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "Servicio de Endocrinología, Hospital Clínico Universitario de Valencia, Valencia, Spain" "etiqueta" => "f" "identificador" => "aff0030" ] 6 => array:3 [ "entidad" => "Centro de Salud Palleter, Castellón, Spain" "etiqueta" => "g" "identificador" => "aff0035" ] 7 => array:3 [ "entidad" => "Centro de Salud de Benigànim, Benigànim (Valencia), Spain" "etiqueta" => "h" "identificador" => "aff0040" ] 8 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital General Universitario, Valencia, Spain" "etiqueta" => "i" "identificador" => "aff0045" ] 9 => array:3 [ "entidad" => "Unión de Mutuas, Castellón, Spain" "etiqueta" => "j" "identificador" => "aff0050" ] 10 => array:3 [ "entidad" => "Departamento de Medicina, Universitat Jaume I, Castellón, Spain" "etiqueta" => "k" "identificador" => "aff0055" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] 1 => array:3 [ "autoresLista" => "José María Cepeda Rodrigo, Juan Cosín Sales, Rafael Durá Belinchón, Enrique Gómez Segado, Saray Monleón Arenós, Carlos Morillas Ariño, Enrique Rodilla Sala, Eduardo Rovira Daudí, David Vicente Navarro" "autores" => array:10 [ 0 => array:1 [ "colaborador" => "Members of the MEJORALO-CV workgroup" ] 1 => array:3 [ "nombre" => "José María" "apellidos" => "Cepeda Rodrigo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">aa</span>" "identificador" => "aff0060" ] ] ] 2 => array:3 [ "nombre" => "Juan" "apellidos" => "Cosín Sales" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">ab</span>" "identificador" => "aff0065" ] ] ] 3 => array:3 [ "nombre" => "Rafael" "apellidos" => "Durá Belinchón" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">ac</span>" "identificador" => "aff0070" ] ] ] 4 => array:3 [ "nombre" => "Enrique" "apellidos" => "Gómez Segado" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">ad</span>" "identificador" => "aff0075" ] ] ] 5 => array:3 [ "nombre" => "Saray" "apellidos" => "Monleón Arenós" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">ae</span>" "identificador" => "aff0080" ] ] ] 6 => array:3 [ "nombre" => "Carlos" "apellidos" => "Morillas Ariño" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">af</span>" "identificador" => "aff0085" ] ] ] 7 => array:3 [ "nombre" => "Enrique" "apellidos" => "Rodilla Sala" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">ag</span>" "identificador" => "aff0090" ] ] ] 8 => array:3 [ "nombre" => "Eduardo" "apellidos" => "Rovira Daudí" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">ah</span>" "identificador" => "aff0095" ] ] ] 9 => array:3 [ "nombre" => "David" "apellidos" => "Vicente Navarro" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">ai</span>" "identificador" => "aff0100" ] ] ] ] "afiliaciones" => array:9 [ 0 => array:3 [ "entidad" => "Department of Internal Medicine, Hospital de la Vega Baja, Orihuela (Alicante), Spain" "etiqueta" => "aa" "identificador" => "aff0060" ] 1 => array:3 [ "entidad" => "Department of Cardiology, Hospital Arnau de Vilanova, Valencia, Spain" "etiqueta" => "ab" "identificador" => "aff0065" ] 2 => array:3 [ "entidad" => "Health Center of Godella, Godella (Valencia), Spain" "etiqueta" => "ac" "identificador" => "aff0070" ] 3 => array:3 [ "entidad" => "Department of Internal Medicine, Hospital de la Marina Baja, Villajoyosa (Alicante), Spain" "etiqueta" => "ad" "identificador" => "aff0075" ] 4 => array:3 [ "entidad" => "Health Center of Vinaroz, Vinaroz, Castellón, Spain" "etiqueta" => "ae" "identificador" => "aff0080" ] 5 => array:3 [ "entidad" => "Department of Endocrinology, University Hospital Doctor Peset, Valencia, Spain" "etiqueta" => "af" "identificador" => "aff0085" ] 6 => array:3 [ "entidad" => "Arterial Hypertension Unit, Department of Internal Medicine, Hospital of Sagunto, Sagunto (Valencia), Spain" "etiqueta" => "ag" "identificador" => "aff0090" ] 7 => array:3 [ "entidad" => "Department of Internal Medicine, University Hospital La Ribera, Alzira (Valencia), Spain" "etiqueta" => "ah" "identificador" => "aff0095" ] 8 => array:3 [ "entidad" => "Department of Internal Medicine, Hospital of Vinalopó, Elche (Alicante), Spain" "etiqueta" => "ai" "identificador" => "aff0100" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "¿Han influido el algoritmo de prescripción de la Administración y las guías de manejo de la dislipemia de la ACC/AHA 2013 en el manejo de la dislipemia? Proyecto MEJORALO-CV" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1506 "Ancho" => 1504 "Tamanyo" => 91508 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Determinants of the lack of lipid control indicated by those surveyed and listed as prevalence (% of total responses).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Background</span><p id="par0005" class="elsevierStylePara elsevierViewall">The publication in 2013 of the clinical practice guidelines (CPGs) of the American College of Cardiology/American Heart Association (ACC/AHA)<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">1</span></a> resulted in intense worldwide controversy by establishing a reduction in overall cardiovascular risk (CVR) as the therapeutic objective for managing dyslipidemia rather than LDL cholesterol (LDL-C) plasma concentrations. In addition, the 2013 CPGs stated that only statins had sufficient evidence for reducing cardiovascular events and are therefore considered the only drug group for use in dyslipidemia. A third controversial issue resulted from the increase in the population to be treated pharmacologically should the criteria of these CPGs be implemented, which included a considerable portion of the population who, up to the publication of the CPGs, had been considered to have normal LDL-C levels.<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The subsequent publication of studies such as the Improved Reduction of Outcomes: Vytorin Efficacy International Trial (IMPROVE-IT)<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">3</span></a> and the reduction in events resulting from never before achieved reductions in plasma LDL-C levels with new drugs such as PCSK9 inhibitors<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">4–6</span></a> resulted in changes to the initial approaches of the 2013 ACC/AHA CPGs.<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">7–9</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In Spain, the increased proportion of the population to be treated pharmacologically with hypolipidemic agents resulted in the Ministry of Health developing prescription algorithms for hypolipidemic agents. The algorithm of the Community of Valencia (CV)<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">10</span></a> is characterized by the support of statins and restrictions on the use of other hypolipidemic agents, which gave rise to new controversy due to the algorithm being regarded as restrictive and interventionist.<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">11–13</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">There is a striking lack of publications assessing how primary care physicians in Spain treat dyslipidemia,<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">14–16</span></a> and none have specifically addressed the impact of the 2013 ACC/AHA CPGs and the health authorities’ prescription algorithms, as has been conducted in other countries.<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">17,18</span></a> The MEJORALO-CV Project was therefore implemented. The existing evidence was discussed in face-to-face meetings, and, through a specific survey, the project determined the management of dyslipidemia by Valencian primary care physicians to establish to what extent the 2013 ACC/AHA CPGs<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">1</span></a> and the prescription algorithm for hypolipidemic agents of the Valencian regional authorities<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">10</span></a> have affected the physicians’ daily practice.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">MEJORALO-CV Project</span><p id="par0025" class="elsevierStylePara elsevierViewall">Under the scientific endorsement of the Valencian Society of Hypertension and Vascular Risk, a scientific committee consisting of primary care specialists (2 members) and other medical specialties (2 internists, an endocrinologist and a cardiologist) involved in cardiometabolic risk conducted an updated review of the literature on dyslipidemia. The committee developed a document with theoretical units of support whose objective was to present the evidence on the therapeutic objectives and strategies and the main approaches of the current CPGs as elements from which to discuss the daily management of dyslipidemia. Between January and November 2016, primary care physicians from 15 of the 24 health departments of Valencia met, grouping the departments based on the number of physicians. After the theoretical contents were presented in each meeting, the physicians answered a structured survey (Appendix 1. See additional material online) with 4 questions on self-declared practitioner data and 21 closed multiple-choice questions divided into the following thematic sections: use of guidelines for managing CVR and dyslipidemia (2 questions), therapeutic objective (1 question), drug treatment (4 questions), self-perceived degree of control (5), laboratory test monitoring (3 questions) and the controversy raised by the 2013 ACC/AHA CPGs (7 questions).</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Study type</span><p id="par0030" class="elsevierStylePara elsevierViewall">Cross-sectional descriptive study based on data from the survey filled in by the meeting participants of the MEJORALO-CV Project.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Statistical analysis</span><p id="par0035" class="elsevierStylePara elsevierViewall">The study employed a convenience sample of participants. To achieve an accuracy of 6% in the calculation of the sample using a 95% confidence interval (bilateral asymptotic to the normal), with correction for finite populations and assuming that the expected proportion of interest is <30%, we estimated that 200 respondents needed to be included. We performed a univariate descriptive analysis of all variables. The quantitative variables are listed with measures of central tendency and dispersion, The qualitative variables are listed with frequencies and percentages. We performed the statistical analysis using with SPSS® version 16.0 (SPSS Inc.).</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Results</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Sample</span><p id="par0040" class="elsevierStylePara elsevierViewall">A total of 199 physicians (mean age [SD], 48.9 [11] years) participated in the survey; 40.3% of the respondents were men. By province, Castellon had the lowest participation (12.8% of all participants), compared with Valencia (42.1%) and Alicante (41.6%). Fifteen of the 24 health departments of Valencia were represented. The participants had 21.3 (11.1) years of self-declared professional experience; 82.6% and 57.3% of the participants had more than 10 and 20 years of experience, respectively.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Therapeutic objectives and self-perceived degree of control</span><p id="par0045" class="elsevierStylePara elsevierViewall">Most of the respondents stated using CPGs for managing dyslipidemia, while 4.2% stated not using any. The most widely used were those of the European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) (37.5%),<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">19,20</span></a> followed by the Valencian government's algorithm<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">10</span></a> and the CPGs of Spanish societies<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">21</span></a> (23.4% and 21.2%, respectively). Some 6.3% and 1.1% of the respondents used the 2013 ACC/AHA CPGs<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">1</span></a> and Adult Treatment Panel (ATP) III CPGs,<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">22</span></a> respectively. For the CVR determination, 2.7% of the physicians stated not using any CPG or validated table, 1.4% stated that they would like to use one but do not have the means, and 13.6% stated that they only use them if the patient is undergoing primary or secondary prevention. Among those that used validated tables to determine the CVR, most used SCORE (55.2%),<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">19,23</span></a> followed by Framingham<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">24</span></a> (23.4%) and Regicor<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">25</span></a> (11.5%).</p><p id="par0050" class="elsevierStylePara elsevierViewall">Eighty-eight percent of the participants employed the plasma LDL-C value as the therapeutic objective, 55% simultaneously considered the overall estimated individual CVR, and 12% only considered the CVR (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">In the respondents’ opinion, their patients’ degree of lipid control was high, with no differences when considering patients with diabetes or those undergoing secondary prevention. Some 65.6% of the respondents stated that in general more than half of their patients achieved good control, percentages that were 68.7% and 68.7% for the patients with diabetes and the patients undergoing secondary prevention, respectively (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>). In decreasing order, a lack of control was blamed (38.2% of respondents) on factors related to the available hypolipidemic drugs (19.1% adverse effects, 19.1% limited efficacy), followed by the lack of patient compliance (31.6%), physician therapeutic inertia (23.4%) and the organization of the healthcare system and the recent cost-containment strategies (12.7%) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Drug management of dyslipidemia</span><p id="par0060" class="elsevierStylePara elsevierViewall">The participants’ stated criteria when choosing a lipid-lowering drug were, in order of importance, the potency in reducing LDL-C (28.6%), the Valencian government's algorithm (23.4%), the safety of the drug (20.4%), the scientific evidence (8.7%), the capacity for reducing triglyceride and HDL-C levels (8.7%), the financial cost for the patient (7.8%) and the cost for the healthcare system (3.7%).</p><p id="par0065" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> shows that the most positively rated drugs, in decreasing order, were statins, ezetimibe and fibrates, while the most negatively rated were resins followed by omega 3 fatty acids. On a scale of 1–6, where 1 is the lowest assessment and 6 is the highest, 83.6%, 64.1%, 60.5%, 34.4%, 16.4%, 10.7% and 8.7% of the respondents gave a score higher than 3 to statins, ezetimibe, fibrates, omega 3 fatty acids and resins, the last of which were behind “other hypolipidemic agents”.</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">When the therapeutic objectives were not achieved, the preferred drug strategy was the combination of drugs (51%), followed by increased dosages of the current drug employed in monotherapy (35%) and changing of the lipid-lowering drug (11%). The use of ezetimibe was proposed in 60% of occasions in combination with statins when there was a lack of appropriate control with these drugs in monotherapy (32% when the statin was being used at standard dosages and 28% when being used at maximum dosages). Ezetimibe was proposed in the remaining 40% of occasions when there was statin intolerance.</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Analytical monitoring</span><p id="par0075" class="elsevierStylePara elsevierViewall">None of the physicians conducted readings of the lipid profile exclusively at baseline (<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>). All of them stated having performed periodic laboratory tests, mostly every 6 months (59.5%). Although small (6.7% for transaminases and 2.6% for plasma creatine kinase), the percentage of physicians who only performed baseline measurements was larger. Similar to that observed with the lipid profile, most of the respondents measured plasma transaminase and creatine kinase levels periodically every 6–12 months.</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Controversy regarding the 2013 ACC/AHA guidelines</span><p id="par0080" class="elsevierStylePara elsevierViewall">For the question “Are you aware of the controversy between the US and European Guidelines?”, 41% answered that they were aware of the controversy. Although 70% of the respondents indicated that this controversy was justified, only 21% stated that their daily practice was affected.</p><p id="par0085" class="elsevierStylePara elsevierViewall">Fifty-one percent of the physicians stated that they knew about the pleiotropic effects of statins (31% stated that they were not aware of these effects, 10% responded that they did not believe in the presence of these effects, and 6% did not answer this question), and 46% prescribed these drugs in the presence of normal plasma LDL-C values.</p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Discussion</span><p id="par0090" class="elsevierStylePara elsevierViewall">Despite the considerable number of general and scientific publications echoing the controversy,<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">2</span></a> the publication of the 2013 ACC/AHA CPGs<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">1</span></a> did not seem to affect the way primary care physicians in Valencia managed dyslipidemia. In contrast, the publication of the Valencian government's algorithm did have an influence, given that a quarter of the physicians in the study stated following them, just behind the ESC/EAS guidelines,<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">19,20</span></a> which were the most widely employed (37.5%). The main parameter consistently employed to establish the therapeutic objectives was the plasma LDL-C level. The participants reported that they measured this parameter every 6–12 months. Due to their greater capacity for reducing plasma LDL-C levels, statins and ezetimibe were also consistently the best rated hypolipidemic agents, with the combination of the two the preferred strategy when the therapeutic objectives were not achieved.</p><p id="par0095" class="elsevierStylePara elsevierViewall">Most of the physicians followed the European guidelines, as shown by the 37.5% of participants who followed the ESC/EAS CPGs for managing dyslipidemia<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">19</span></a> and cardiovascular prevention<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">20</span></a> and by the 55.5% who employed SCORE tables<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">20,23</span></a> to estimate the CVR, with approaches different from those proposed by the 2013 ACC/AHA CPGs.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">1</span></a> In the SINCOPA study, 291 Spanish cardiologists and 564 primary care physicians responded to a survey on their management of patients discharged after an acute coronary syndrome. The study also observed that most of the participants employed the ESC/EAS CPGs,<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">19,20</span></a> although to a larger extent than the present study (85.4% for the cardiologist group and 65.4% for the primary care physicians).<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">14</span></a> The differences in the use of the ESC/EAS CPGs between the SINCOPA study and the present survey could be due to the introduction of the Valencian government's algorithm into clinical practice,<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">10</span></a> which was followed by 23.4% of the respondents. These results highlight the significant influence that local indications have in the decision-making process in primary care, given that these were the CPGs followed in the SINCOPA study by 14.2% of the primary care physicians versus 1.8% of the cardiologists. It is difficult to assess the impact of the algorithm of the Valencian Ministry of Health,<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">10</span></a> because it focused on the prescription of the lipid-lowering drug, establishing therapeutic objectives consistent with the ESC/EAS CPGs<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">19,20</span></a> and the SCORE tables.<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">20,23</span></a> Despite the significant percentage of physicians who stated that they followed this algorithm, it is possible to assume it had a minor effect, given that, unlike the indications of this document,<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">10</span></a> the physicians who participated in the present study considered ezetimibe the second most highly rated lipid-lowering drug and a key element in the combination strategy, while the Valencia algorithm explicitly restricts the use of this drug both in monotherapy and in combination.<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">10</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">Most of the respondents stated that they often used validated CPGs; however, there was considerable room for improvement, given that 4.2% and 18.2% stated having not employed any CPG or cardiovascular risk scale, respectively. This room for improvement has been confirmed in the few studies on dyslipidemia in primary care in Spain, which have shown that only 46% of patients are given an estimate of their cardiovascular risk using SCORE, as illustrated by the Dislip-EM study.<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">26</span></a> The implementation of electronic tools for estimating an individual's cardiovascular risk would be a simple and realistic solution while standardizing the management of patients with dyslipidemia.<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">27</span></a> Another area for improvement worth mentioning with a potential benefit in terms of reducing unnecessary resource consumption is the adjustment of the number of periodic laboratory tests to that recommended in the guidelines, which is much lower than that typically performed in Spain.<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">28</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">In contrast to studies similar to the current study, the physicians had a very poor self-perception of the degree of control, with only 8.2% stating that at least 75% of their patients had good control. This finding contrasts with the opinions collected in the SINCOPA study,<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">14</span></a> with 42% and 19.9% of the cardiologists and primary care physicians stating that their patients had such lipid control rates. In terms of the low degree of control perceived for most patients with dyslipidemia, a higher percentage of physicians in the present study thought that 75–100% of the patients with diabetes or the patients in secondary prevention had their LDL-C levels controlled (19.5% for both groups). These differences might be explained by the focus of the SINCOPA study<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">14</span></a> on the specific disease of ischemic heart disease, which has a marked degree of sensitization among practitioners. This would explain the high percentage of cardiologists with a more satisfactory view of the degree of control compared with primary care. In any case, these results contrast with the reality presented by population studies such as the Nutrition and Cardiovascular Risk Study (ENRICA), with overall rates of control of approximately 13%.<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">29</span></a> The DYSIS-España study showed that, despite treatment with statins, only one fifth of the patients achieved the objectives established by the current CPGs.<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">30</span></a> These results are in line with those of the present study, all of which point to an unjustifiably optimistic view by cardiologists compared with primary care physicians. We can deduce in all cases that there is a high degree of complacency among physicians when assessing the efficacy of their intervention in the control of dyslipidemia and that this complacency appears to be higher among specialized care physicians than primary care physicians and in the population with increased cardiovascular risk.<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">14</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">This complacency is reinforced when we consider the factors that, in the physicians’ opinion, determine poor lipid control, Which were mostly attributed to drug-related factors or to the patients, with less than a quarter attributing the problem to the physicians themselves (clinical inertia).<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">31</span></a> This finding is consistent throughout the existing studies and once again contrasts with reality, with clinical inertia rates approaching 40% in Spain.<a class="elsevierStyleCrossRefs" href="#bib0330"><span class="elsevierStyleSup">32,33</span></a> To illustrate this, the results of the recent Spanish population registries such as the Valencian cardiometabolic study ESCARVAL<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">33</span></a> and ENRICA<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">29</span></a> indicated diagnostic inertia and therapeutic inertia rates of 63.5% and 50%, respectively, above those observed in the present study. The relevance of these findings is even greater when we consider that more patients should be administered drugs and that a non-negligible portion of those who are treated need dosage increases, both in primary and secondary prevention.<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">34</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">Lastly, the current results indicate that the controversy raised by the 2013 ACC/AHA dyslipidemia guidelines did not affect the patients’ management in primary care, given that most of the respondents maintained the therapeutic objective of plasma LDL-C levels, the positive assessment of non-statin hypolipidemic agents and the stated implementation of periodic lipid laboratory tests. It is worth considering that one of the reasons for the low impact was the lack of awareness of these CPGs and of the controversy that accompanied their publication, as illustrated by the fact that only 41% of the participants responded positively to the explicit question regarding this issue. At the other extreme, we found that the therapeutic algorithm established by the Valencian government did affect the daily practice of primary care physicians, as shown by the fact that the algorithm was the most followed CPG after the ESC/EAS guidelines,<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">19,20</span></a> even above the national guidelines.<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">21</span></a> The repercussions of this finding are difficult to establish. The Valencian government's algorithm focuses on prescriptive aspects. The respondents’ assessment of non-statin drugs (especially ezetimibe) seems to infer a low impact on actual practice, given that this assessment of available hypolipidemic agents is more in keeping with the indications of European<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">19,20</span></a> and national guidelines<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">21</span></a> and highly relevant studies such as IMPROVE-IT.<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">3</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">One of the main limitations of this study is the sample's selection bias. Active participation in these types of activities selects participants that are more involved in the field of study. One of the study's strengths is that it reflects standard clinical practice by employing an anonymous survey, which ensures the internal consistency and correlation of the responses to the various survey questions. The study's broad geographical coverage helps reinforce, although indirectly, the representativeness of the sample. The results of the study are, however, only applicable to Spanish territories that have implemented prescription algorithms of the health ministry and have access to patients’ electronic medical history, as was the case for Valencia during the implementation of the MEJORALO-CV program. In contrast to the previously mentioned limitations, the study's main strength is that it is the only article to date that has analyzed the effect of the publication of the 2013 ACC/AHA CPGs and the prescription algorithms of the health ministry, which, due to their high-profile impact, are expected to affect the daily management of dyslipidemia.</p><p id="par0125" class="elsevierStylePara elsevierViewall">We can conclude that the controversy resulting from the publication of the 2013 ACC/AHA CPGs on dyslipidemia management barely affected the daily routine of Valencian primary care physicians, despite the fact that an appreciable percentage of the practitioners were aware of concepts such as statin pleiotropism. In contrast, the prescription algorithm of the Valencian government was followed extensively, although it does not appear that the algorithm changed key aspects such as the preference for using certain hypolipidemic agents over others. The repercussion on the degree of lipid control and cardiovascular caseloads is yet to be observed. In any case, we have detected areas for improvement, including reducing the number of routine laboratory tests, conducting efforts to reduce clinical inertia and systematically implementing cardiovascular risk assessment scales and validated CPGs for dyslipidemia.</p><p id="par0130" class="elsevierStylePara elsevierViewall">Lastly, we should mention the responsibility of the main scientific societies regarding the publication of the CPGs, who should seek to provide assistance in the daily clinical-decision making process.<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">2</span></a> There is a clear and significant change in the evolution of the most recent editions of the ACC/AHA CPGs for managing dyslipidemia,<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">1</span></a> which, in their 2018 version,<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">8,9</span></a> return to the general approaches from prior to the 2013 editions.</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Funding</span><p id="par0135" class="elsevierStylePara elsevierViewall">The project received financial support from <span class="elsevierStyleGrantSponsor" id="gs1">Merck Sharp & Dohme Española S.A.</span> (MSD), which did not in any way interfere with the data collection, the data interpretation or the drafting of the present manuscript.</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conflicts of interest</span><p id="par0140" class="elsevierStylePara elsevierViewall">The authors declare that there are no conflicts of interest beyond the collaboration in various training activities with various pharmaceutical laboratories.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres1346216" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Method" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1238678" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1346217" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Método" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1238677" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Background" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Materials and methods" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "MEJORALO-CV Project" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Study type" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Statistical analysis" ] ] ] 6 => array:3 [ "identificador" => "sec0030" "titulo" => "Results" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "sec0035" "titulo" => "Sample" ] 1 => array:2 [ "identificador" => "sec0040" "titulo" => "Therapeutic objectives and self-perceived degree of control" ] 2 => array:2 [ "identificador" => "sec0045" "titulo" => "Drug management of dyslipidemia" ] 3 => array:2 [ "identificador" => "sec0050" "titulo" => "Analytical monitoring" ] 4 => array:2 [ "identificador" => "sec0055" "titulo" => "Controversy regarding the 2013 ACC/AHA guidelines" ] ] ] 7 => array:2 [ "identificador" => "sec0060" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0065" "titulo" => "Funding" ] 9 => array:2 [ "identificador" => "sec0070" "titulo" => "Conflicts of interest" ] 10 => array:2 [ "identificador" => "xack466152" "titulo" => "Acknowledgements" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-03-15" "fechaAceptado" => "2019-08-13" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1238678" "palabras" => array:4 [ 0 => "Dyslipidemia" 1 => "Statins" 2 => "Primary care" 3 => "Clinical practice guidelines" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1238677" "palabras" => array:4 [ 0 => "Dislipemia" 1 => "Estatinas" 2 => "Atención primaria" 3 => "Guía de práctica clínica" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To determine the management of dyslipidemia in primary care after the publication of the American College of Cardiology/American Heart Association (ACC/AHA) 2013 guidelines and Valencian government's algorithm.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Method</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">We conducted a cross-sectional descriptive study that employed a survey of primary care physicians of the Community of Valencia between January and October 2016.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A total of 199 physicians (mean age, 48.9<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>11.0 years; experience, 21.3<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>11.1 years) participated in the survey. The most followed guidelines were those of the European Society of Cardiology (37.5% of respondents) and Valencian government (23.4% of respondents). Some 6.3% of the respondents followed the 2013 ACC/AHA guidelines, and 88.0% established objectives based on LDL cholesterol and cardiovascular risk. The choice of lipid-lowering drug was based on its LDL cholesterol lowering capacity (28.6% of respondents), on the Valencian government's algorithm (23.4%) and on the drug's safety (20.4%). Statins, ezetimibe and fibrates were the preferred hypolipemiant agents, and their combination (51% of respondents) and dosage increases (35%) were the strategies employed for poor control. Lipid profile and transaminase and creatine kinase levels were measured every 6 (59.5%, 52.3% and 54.3% of respondents, respectively) or 12 months (25.1%, 29.2% and 30.3%, respectively). Forty-one percent of the respondents were aware of the controversy surrounding the 2013 ACC/AHA guidelines. Although 60% of the respondents acknowledged its relevance, only 21% changed their daily practices accordingly.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The Valencian government's algorithm had a greater impact than the 2013 ACC/AHA guidelines in primary care in Valencia. Areas for improvement included the low use of validated guidelines and risk tables and the streamlining of laboratory test periodicity.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Method" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Conocer el manejo de la dislipemia en atención primaria tras la publicación de la Guía de la <span class="elsevierStyleItalic">American College of Cardiology/American Heart Association</span> (ACC/AHA) del año 2013 y el algoritmo de la Administración.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Método</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio transversal descriptivo con encuesta a médicos de atención primaria de la Comunidad Valenciana entre enero y octubre de 2016.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Participaron 199 facultativos con una media (desviación típica) de 48,9 (11) años de edad y 21,3 (11,1) años de experiencia. Las guías más seguidas eran las de la <span class="elsevierStyleItalic">European Society of Cardiology</span> (37,5%) y las de la Administración (23,4%). El 6,3% seguía la de la ACC/AHA 2013. El 88% establecía objetivos según colesterol LDL y riesgo cardiovascular. La elección del hipolipemiante estaba basada en su capacidad reductora de colesterol LDL (28,6%), algoritmo de la Administración (23,4%) y seguridad (20,4%). Estatinas, ezetimiba y fibratos eran los hipolipemiantes preferidos, y la combinación (51%) e incremento de dosis (35%) las estrategias en ausencia de control. Se determinaba perfil lipídico, transaminasas y creatincinasa cada 6 (59,5; 52,3 y 54,3%, respectivamente) o 12 meses (25,1; 29,2 y 30,3%, respectivamente). Un 41% era conocedor de la polémica con la Guía ACC/AHA 2013, y aunque un 60% reconocía su relevancia, solo un 21% modificó su quehacer diario por ella.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El algoritmo de la Administración tuvo mayor impacto que la Guía ACC/AHA 2013 en atención primaria. Campos de mejora fueron el bajo uso de guías y tablas de riesgo validadas, y racionalización de la periodicidad de las analíticas.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Método" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as: Giner Galvañ V, Bonig Trigueros I, Fácila Rubio L, Morillas Blasco P, Martínez Hervás S, Pascual Fuster V, et al. ¿Han influido el algoritmo de prescripción de la Administración y las guías de manejo de la dislipemia de la ACC/AHA 2013 en el manejo de la dislipemia? Proyecto MEJORALO-CV. Rev Clin Esp. 2020;220:282–289.</p>" ] 1 => array:3 [ "etiqueta" => "◊" "nota" => "<p class="elsevierStyleNotepara" id="npar0015">The other members of the MEJORALO-CV workgroup are listed in <a class="elsevierStyleCrossRef" href="#sec0075">Appendix 1</a>.</p>" "identificador" => "fn0005" ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:2 [ 0 => array:4 [ "apendice" => "<p id="par0150" class="elsevierStylePara elsevierViewall">José María Cepeda Rodrigo: Department of Internal Medicine, Hospital de la Vega Baja, Orihuela (Alicante); Juan Cosín Sales: Department of Cardiology, Hospital Arnau de Vilanova, Valencia; Rafael Durá Belinchón: Health Center of Godella, Godella (Valencia); Enrique Gómez Segado: Department of Internal Medicine, Hospital de la Marina Baja, Villajoyosa (Alicante); Saray Monleón Arenós: Health Center of Vinaroz, Vinaroz, Castellón; Carlos Morillas Ariño: Department of Endocrinology, University Hospital Doctor Peset, Valencia; Enrique Rodilla Sala: Arterial Hypertension Unit, Department of Internal Medicine, Hospital of Sagunto, Sagunto (Valencia); Eduardo Rovira Daudí: Department of Internal Medicine, University Hospital La Ribera, Alzira (Valencia); David Vicente Navarro: Department of Internal Medicine, Hospital of Vinalopó, Elche (Alicante).</p>" "etiqueta" => "Appendix 1" "titulo" => "Members of the MEJORALO-CV workgroup" "identificador" => "sec0075" ] 1 => array:4 [ "apendice" => "<p id="par0160" class="elsevierStylePara elsevierViewall">The following are the supplementary data to this article:<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>" "etiqueta" => "Appendix B" "titulo" => "Supplementary data" "identificador" => "sec0085" ] ] ] ] "multimedia" => array:6 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1506 "Ancho" => 1504 "Tamanyo" => 91508 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Determinants of the lack of lipid control indicated by those surveyed and listed as prevalence (% of total responses).</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Abbreviations</span>: C, cholesterol; CVR, individual overall cardiovascular risk; HDL, high-density lipoprotein; LDL, low-density lipoprotein.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Parameter \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Percentage of respondents who considered the parameter \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">LDL-C<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>CVR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">55% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">LDL-C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CVR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Total C<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>LDL-C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Non-HDL-C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HDL-C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Triglycerides \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1% \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2309647.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Parameters employed by the respondents to establish treatment objectives.</p>" ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Abbreviations</span>: DK/NA, Don’t know/No answer.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="\n \t\t\t\t\ttable-head\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Population \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="5" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Self-perceived degree of lipid control, %</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">0–25 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">26–49 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">50–74 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">75–100 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">DK/NA \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">General \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23.4% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">57.4% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.2% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.2% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Diabetics \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.1% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23.4% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">49.2% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19.5% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.1% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Secondary prevention \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.1% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23.4% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">49.2% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19.5% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.1% \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2309649.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Self-perceived degree of lipid control by the respondents in the general population, patients with diabetes and patients in secondary prevention.</p>" ] ] 3 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Abbreviations</span>: DK/NA, Don’t know/No answer.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="\n \t\t\t\t\ttable-head\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Drug \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="7" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Percentage distribution of points awarded to the main lipid-lowering drug groups<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a></th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">1 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">2 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">3 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">4 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">5 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">6 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">DK/NA \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Statins \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">79.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ezetimibe \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Fibrates \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">34.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Omega 3 acids \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Resins \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">59 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Others \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">62.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2309646.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Point scale where the lowest score corresponds to the lowest number (1) and the highest corresponds to 6. The higher the score, the better the assessment.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Qualitative assessment of the main drug groups for managing dyslipidemia expressed as the score given by the respondents.</p>" ] ] 4 => array:8 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at4" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Abbreviations</span>: CK, creatine kinase plasmatic; NR, no response.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="\n \t\t\t\t\ttable-head\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Analytical parameter \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="7" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Periodicity, %</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Only baseline \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Monthly \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Quarterly \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Every six months \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Annually \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Biennial \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">NR \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lipid profile \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">59.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Transaminases \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">52.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Plasma CK \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">54.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2309648.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Periodicity in conducting laboratory tests expressed as the time period stated by the respondents (% of responses).</p>" ] ] 5 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:2 [ "fichero" => "mmc1.pdf" "ficheroTamanyo" => 116032 ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:34 [ 0 => array:3 [ "identificador" => "bib0175" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "American College of Cardiology/American Heart Association Task Force on Practice Guidelines" "etal" => true "autores" => array:6 [ 0 => "N.J. Stone" 1 => "J.G. Robinson" 2 => "A.H. Lichtenstein" 3 => "C.N. Bairey Merz" 4 => "C.B. Blum" 5 => "R.H. Eckel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/01.cir.0000437738.63853.7a" "Revista" => array:8 [ "tituloSerie" => "Circulation" "fecha" => "2014" "volumen" => "129" "numero" => "25 Suppl. 2" "paginaInicial" => "S1" "paginaFinal" => "S45" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24222016" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0165032716311119" "estado" => "S300" "issn" => "01650327" ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0180" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Overview of guidelines for the management of dyslipidemia: EU perspectives" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "V. Giner-Galvañ" 1 => "M.J. Esteban-Giner" 2 => "V. Pallarés-Carratalá" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2147/VHRM.S89038" "Revista" => array:6 [ "tituloSerie" => "Vasc Health Risk Manag" "fecha" => "2016" "volumen" => "12" "paginaInicial" => "357" "paginaFinal" => "369" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27660458" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0185" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ezetimibe added to statin therapy after acute coronary syndromes" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "IMPROVE-IT Investigators" "etal" => true "autores" => array:6 [ 0 => "C.P. Cannon" 1 => "M.A. Blazing" 2 => "R.P. Giugliano" 3 => "A. McCagg" 4 => "J.A. White" 5 => "P. Theroux" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMoa1410489" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2015" "volumen" => "372" "paginaInicial" => "2387" "paginaFinal" => "2397" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26039521" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0190" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efficacy and safety of evolocumab in reducing lipids and cardiovascular events" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "Open-Label Study of Long-Term Evaluation against LDL Cholesterol (OSLER) Investigators" "etal" => true "autores" => array:6 [ 0 => "M.S. Sabatine" 1 => "R.P. Giugliano" 2 => "S.D. Wiviott" 3 => "F.J. Raal" 4 => "D.J. Blom" 5 => "J. Robinson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "N Engl J Med" "fecha" => "2015" "volumen" => "37" "paginaInicial" => "1500" "paginaFinal" => "1509" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0195" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efficacy and safety of alirocumab in reducing lipids and cardiovascular events" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "ODYSSEY LONG TERM Investigators" "etal" => true "autores" => array:6 [ 0 => "J.G. Robinson" 1 => "M. Farnier" 2 => "M. Krempf" 3 => "J. Bergeron" 4 => "G. Luc" 5 => "M. Averna" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMoa1501031" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2015" "volumen" => "372" "paginaInicial" => "1489" "paginaFinal" => "1499" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25773378" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0200" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evolocumab and clinical outcomes in patients with cardiovascular disease" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "FOURIER Steering Committee and Investigators" "etal" => true "autores" => array:6 [ 0 => "M.S. Sabatine" 1 => "R.P. Giugliano" 2 => "A.C. Keech" 3 => "N. Honarpour" 4 => "S.D. Wiviot" 5 => "S.A. Murphy" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMoa1615664" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2017" "volumen" => "376" "paginaInicial" => "1713" "paginaFinal" => "1722" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28304224" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0205" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "2017 focused update of the 2016 ACC expert consensus decision pathway on the role of non-statin therapies for LDL-cholesterol lowering in the management of atherosclerotic cardiovascular disease risk: a report of the American College of Cardiology Task Force on expert consensus decision pathways" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D.M. Lloyd-Jones" 1 => "P.B. Morris" 2 => "C.M. Ballantyne" 3 => "K.K. Birtcher" 4 => "D.D. Daly Jr." 5 => "S.M. DePalma" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jacc.2017.07.745" "Revista" => array:7 [ "tituloSerie" => "J Am Coll Cardiol" "fecha" => "2017" "volumen" => "70" "paginaInicial" => "1785" "paginaFinal" => "1822" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28886926" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0165032714004133" "estado" => "S300" "issn" => "01650327" ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0210" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Systematic review for the 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "P.W.F. Wilson" 1 => "T.S. Polonsky" 2 => "M.D. Miedema" 3 => "A. Khera" 4 => "A.S. Kosinski" 5 => "J.T. Kuvin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIR.0000000000000626" "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "2019" "volumen" => "139" "paginaInicial" => "e1144" "paginaFinal" => "e1150" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30586775" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0215" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Recent AHA/ACC guidelines on cholesterol management expands the role of the clinical laboratory" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J. Cao" 1 => "S. Devaraj" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.cca.2019.04.002" "Revista" => array:6 [ "tituloSerie" => "Clin Chim Acta" "fecha" => "2019" "volumen" => "495" "paginaInicial" => "82" "paginaFinal" => "84" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30953613" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0220" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Comité de posicionamiento terapéutico de la Comunidad Valenciana. Criterios de consenso por los que se establece el algoritmo de decisión terapéutica corporativo de la Agencia Valenciana de Salud para el manejo y prescripción de la terapia hipolipemiante: hipercolesterolemia pura, hipertrigliceridemia pura e hiperlipidemia mixta (Documento de fecha 07.06.2013). Available from: <a target="_blank" href="http://www.san.gva.es/web/dgfps/adt-programa-de-consenso-de-algoritmos-decision-terapeutica-corporativa">http://www.san.gva.es/web/dgfps/adt-programa-de-consenso-de-algoritmos-decision-terapeutica-corporativa</a> [last consultation: May 2019]" ] ] ] 10 => array:3 [ "identificador" => "bib0225" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Para salir del hoyo, lo primero es dejar de cavar" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S. Peiró" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.aprim.2012.08.001" "Revista" => array:6 [ "tituloSerie" => "Aten Primaria" "fecha" => "2012" "volumen" => "44" "paginaInicial" => "691" "paginaFinal" => "694" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22980942" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0230" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Algoritmos terapéuticos: ¿Qué, porqué y porqué no?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M. Belmonte" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Soc Val Reuma" "fecha" => "2014" "volumen" => "5" "paginaInicial" => "1" "paginaFinal" => "2" ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0235" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "La administración contra la libertad de prescripción del médico" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "F. Francés" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Gac Int Cienc Forense" "fecha" => "2015" "volumen" => "17" "paginaInicial" => "2" "paginaFinal" => "4" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0240" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Atención al alta en pacientes con síndrome coronario agudo y control de la dislipidemia en la práctica clínica en España: Estudio SINCOPA" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "en nombre de los investigadores del estudio SINCOPA" "etal" => false "autores" => array:3 [ 0 => "N. Murga" 1 => "E. Ruiz" 2 => "V. Pascual" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clin Investig Arterioscler" "fecha" => "2015" "volumen" => "27" "paginaInicial" => "272" "paginaFinal" => "279" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0245" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Control de la dislipidemia aterogénica en paciente diabético tipo 2. Procedimientos en la práctica clínica. Estudio LIPEDIA" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "en nombre de los investigadores del estudio LIPEDIA" "etal" => false "autores" => array:3 [ 0 => "V. Pascual" 1 => "E. Ruiz" 2 => "X. Pintò" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.arteri.2014.06.002" "Revista" => array:6 [ "tituloSerie" => "Clin Investig Arterioscler" "fecha" => "2015" "volumen" => "27" "paginaInicial" => "45" "paginaFinal" => "56" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25112553" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0250" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Manejo actual de la hiperlipemia en pacientes dados de alta con el diagnóstico de síndrome coronario agudo" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Chacón-Piñero" 1 => "J.M. Nogales-Asensio" 2 => "A. Martínez-Carapeto" 3 => "M. Lledó-Gómez" 4 => "M. Merchán-Cuenda" 5 => "B. Bengla-Limpo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rec.2015.09.009" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Cardiol" "fecha" => "2016" "volumen" => "69" "paginaInicial" => "83" "paginaFinal" => "84" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26620973" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0255" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Impact of the 2013 American College of Cardiology/American Heart Association cholesterol guidelines on the prescription of high-intensity statins in patients hospitalized for acute coronary syndrome or stroke" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Valentino" 1 => "J. Al Danaf" 2 => "A. Panakos" 3 => "L. Ragupathi" 4 => "D. Duffy" 5 => "D. Whellan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ahj.2016.07.024" "Revista" => array:7 [ "tituloSerie" => "Am Heart J" "fecha" => "2016" "volumen" => "181" "paginaInicial" => "130" "paginaFinal" => "136" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27823684" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0165032714008143" "estado" => "S300" "issn" => "01650327" ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0260" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Use of high-intensity statins for patients with atherosclerotic cardiovascular disease in the Veterans Affairs Health System: practice impact of the new cholesterol guidelines" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "F. Rodríguez" 1 => "S. Lin" 2 => "D.J. Maron" 3 => "J.W. Knowles" 4 => "S.S. Virani" 5 => "P.A. Heidenreich" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ahj.2016.09.007" "Revista" => array:6 [ "tituloSerie" => "Am Heart J" "fecha" => "2016" "volumen" => "182" "paginaInicial" => "97" "paginaFinal" => "102" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27914506" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0265" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "2016 ESC/EAS guidelines for the management of dyslipidaemias" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "ESC Scientific Document Group" "etal" => true "autores" => array:6 [ 0 => "A.L. Catapano" 1 => "I. Graham" 2 => "G. De Backer" 3 => "O. Wiklund" 4 => "M.J. Chapman" 5 => "H. Drexel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/eurheartj/ehw272" "Revista" => array:6 [ "tituloSerie" => "Eur Heart J" "fecha" => "2016" "volumen" => "37" "paginaInicial" => "2999" "paginaFinal" => "3058" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27567407" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0270" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "European guidelines on cardiovascular disease prevention in clinical practice (version 2012) The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts)" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "European Association for Cardiovascular Prevention & Rehabilitation (EACPR) ESC Committee for Practice Guidelines (CPG)" "etal" => true "autores" => array:6 [ 0 => "J. Perk" 1 => "G. de Backer" 2 => "H. Gohlke" 3 => "I. Graham" 4 => "Z. Reiner" 5 => "M. Verschuren" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/eurheartj/ehs092" "Revista" => array:6 [ "tituloSerie" => "Eur Heart J" "fecha" => "2012" "volumen" => "33" "paginaInicial" => "1635" "paginaFinal" => "1701" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22555213" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0275" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Posicionamiento del Comité Español Interdisciplinario de Prevención Cardiovascular y la Sociedad Española de Cardiología en el tratamiento de las dislipemias. Divergencia entre las guías europea y estadounidense" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.M. Lobos" 1 => "E. Galve" 2 => "M.A. Royo-Bordonada" 3 => "E. Alegría Ezquerra" 4 => "P. Armario" 5 => "C. Brotons Cuixart" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rec.2014.05.008" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Cardiol" "fecha" => "2014" "volumen" => "67" "paginaInicial" => "913" "paginaFinal" => "919" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25443815" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0280" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Third report of the National Cholesterol Education Program (NCEP) Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report" "autores" => array:1 [ 0 => array:2 [ "colaboracion" => "National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III)" "etal" => false ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "2002" "volumen" => "106" "paginaInicial" => "3143" "paginaFinal" => "3221" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12485966" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0285" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "SCORE project group" "etal" => true "autores" => array:6 [ 0 => "R. Conroy" 1 => "K. Pyörälä" 2 => "A.P. Fitzgerald" 3 => "S. Sans" 4 => "A. Menotti" 5 => "G. De Backer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0195-668x(03)00114-3" "Revista" => array:6 [ "tituloSerie" => "Eur Heart J" "fecha" => "2003" "volumen" => "24" "paginaInicial" => "987" "paginaFinal" => "1003" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12788299" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0290" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "General cardiovascular risk profile for use in primary care: the Framingham Heart Study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.B. D’Agostino" 1 => "R.S. Vasan" 2 => "M.J. Pencina" 3 => "P.A. Wolf" 4 => "M. Cobain" 5 => "J.M. Massaro" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIRCULATIONAHA.107.699579" "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "2008" "volumen" => "117" "paginaInicial" => "743" "paginaFinal" => "753" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18212285" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0295" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Estimación del riesgo coronario en España mediante la ecuación de Framingham calibrada" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Marrugat" 1 => "P. Solanas" 2 => "R. D’Agostino" 3 => "L. Sullivan" 4 => "J. Ordovás" 5 => "F. Cordón" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0300-8932(03)76861-4" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Cardiol" "fecha" => "2003" "volumen" => "56" "paginaInicial" => "253" "paginaFinal" => "256" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12622955" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0300" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluación del manejo de la dislipemia en consultas de atención primaria: resultados de una auditoría clínica" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "y grupo colaborativo estudio Dislip-EM" "etal" => false "autores" => array:6 [ 0 => "E. Mengíbar" 1 => "C. López" 2 => "J. Bóveda" 3 => "M. Campíñez" 4 => "L.A. Pérula" 5 => "M.P. Lora" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Fam Andal" "fecha" => "2015" "volumen" => "16" "paginaInicial" => "213" "paginaFinal" => "221" ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0305" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalencia y control de factores de riesgo cardiovascular en la población general: ¿Qué nos dice la historia clínica electrónica?" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "@GPC-ICS Group" "etal" => true "autores" => array:6 [ 0 => "A. Catalán-Ramos" 1 => "J.M. Verdú" 2 => "M. Grau" 3 => "M. Iglesias-Rodal" 4 => "J.L. del Val García" 5 => "A. Consola" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Aten Primaria" "fecha" => "2014" "volumen" => "46" "paginaInicial" => "15" "paginaFinal" => "24" ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0310" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "titulo" => "Grupo de Trabajo de la SEC para la guía ESC 2016 sobre el tratamiento de las dislipemias, revisores expertos para la guía ESC 2016 sobre tratamiento de las dislipemias y Comité de Guías de la SEC. Comentarios a la guía ESC/EAS 2016 sobre el tratamiento de las dislipemias" ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rec.2017.01.001" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Cardiol" "fecha" => "2017" "volumen" => "70" "paginaInicial" => "72" "paginaFinal" => "77" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28131410" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0315" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Magnitud y manejo de la hipercolesterolemia en la población adulta de España, 2008-2010: el estudio ENRICA" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Guallar-Castillón" 1 => "M. Gil-Montero" 2 => "L.M. León-Muñoz" 3 => "A. Graciani" 4 => "A. Bayán-Bravo" 5 => "J.M. Taboada" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.recesp.2012.02.005" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Cardiol" "fecha" => "2012" "volumen" => "65" "paginaInicial" => "551" "paginaFinal" => "558" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22483404" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0320" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalencia y características de la dislipemia en pacientes en prevención primaria y secundaria tratados con estatinas en España. Estudio DYSIS-España" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.R. González-Juanatey" 1 => "J. Millán" 2 => "E. Alegría" 3 => "C. Guijarro" 4 => "J.V. Lozano" 5 => "G.C. Vitale" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.recesp.2010.10.030" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Cardiol" "fecha" => "2011" "volumen" => "64" "paginaInicial" => "286" "paginaFinal" => "294" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21411216" "web" => "Medline" ] ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0325" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical inertia in hypertension: a new holistic and practical concept within the cardiovascular continuum and clinical care process" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "V. Pallarés-Carratalá" 1 => "I. Bonig-Trigueros" 2 => "A. Palazón-Bru" 3 => "M.J. Esteban-Giner" 4 => "M.J. Gil-Guillén" 5 => "V. Giner-Galvañ" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1080/08037051.2019.1657769" "Revista" => array:5 [ "tituloSerie" => "Blood Press" "fecha" => "2019" "paginaInicial" => "1" "paginaFinal" => "12" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32228237" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0330" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Is the physician's behavior in dyslipidemia diagnosis in accordance with guidelines? Cross-sectional Escarval study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Palazón-Bru" 1 => "V.F. Gil-Guillén" 2 => "D. Orozco-Beltrán" 3 => "V. Pallarés-Carratalá" 4 => "F. Valls-Roca" 5 => "C. Sanchís-Domenech" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1371/journal.pone.0091567" "Revista" => array:5 [ "tituloSerie" => "PLOS ONE" "fecha" => "2014" "volumen" => "9" "paginaInicial" => "e91567" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24626597" "web" => "Medline" ] ] ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0335" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "en nombre de los investigadores del estudio INERCIA Inercia terapéutica en el manejo extrahospitalario de la dislipemia en pacientes con cardiopatía isquémica. Estudio Inercia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "P. Lázaro" 1 => "N. Murga" 2 => "D. Aguilar" 3 => "M.A. Hernández-Presa" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Esp Cardiol" "fecha" => "2010" "volumen" => "63" "paginaInicial" => "1428" "paginaFinal" => "1437" ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib0340" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Situación actual de la dislipemia en España: la visión del cardiólogo" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A. Cordero" 1 => "L. Fácila" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Rev Esp Cardiol Supl" "fecha" => "2015" "volumen" => "15" "numero" => "A" "paginaInicial" => "2" "paginaFinal" => "7" "itemHostRev" => array:3 [ "pii" => "S016517811400393X" "estado" => "S300" "issn" => "01651781" ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack466152" "titulo" => "Acknowledgements" "texto" => "<p id="par0145" class="elsevierStylePara elsevierViewall">The authors would like to thank Exilio SAL, by their support as Technical Secretary of the MEJORALO-CV Project.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/22548874/0000022000000005/v1_202006100751/S2254887419302279/v1_202006100751/en/main.assets" "Apartado" => array:4 [ "identificador" => "1901" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original Articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22548874/0000022000000005/v1_202006100751/S2254887419302279/v1_202006100751/en/main.pdf?idApp=WRCEE&text.app=https://revclinesp.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887419302279?idApp=WRCEE" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2023 March | 13 | 3 | 16 |
| 2020 October | 1 | 0 | 1 |
