Please use this identifier to cite or link to this item: https://hdl.handle.net/10316/107356
Title: CODAP: um consenso multidisciplinar sobre a definição, diagnóstico e tratamento da dislipidemia aterogénica em Portugal
Other Titles: CODAP: A multidisciplinary consensus among Portuguese experts on the definition, detection and management of atherogenic dyslipidemia
Authors: Mello E Silva, Alberto
Aguiar, Carlos
Sequeira Duarte, João
Couto, Luciana
Veríssimo, Manuel Teixeira 
Marques da Silva, Pedro
Keywords: Dislipidemia aterogénica; c-LDL; Colesterol não-HDL; Triglicerídeos; Fenofibrato; Risco cardiovascular residual; Atherogenic dyslipidemia; Low-density lipoprotein cholesterol; Non-high-density lipoprotein cholesterol; Triglycerides; Fenofibrate; Residual cardiovascular risk
Issue Date: Aug-2019
Publisher: Sociedade Portuguesa De Cardiologia
Project: Tecnimede 
Serial title, monograph or event: Revista Portuguesa de Cardiologia
Volume: 38
Issue: 8
Abstract: Introduc¸a˜o e objetivos: A dislipidemia aterogénica contribui consideravelmente para o risco residual de doenc¸a cardiovascular (DCV); não obstante, esta patologia encontra-se subdiagnosticada e submedicada. O objetivo deste estudo foi analisar a opinião dos especialistas portugueses e gerar um consenso sobre o diagnóstico e o tratamento da dislipidemia aterogénica, bem como promover a uniformizac¸ão da prática clínica neste contexto. Métodos: Este estudo consistiu na aplicac¸ão de um questionário a um painel de peritos seguindo uma metodologia Delphi modificada. Resultados: A maioria dos itens (88,4%) foi consensual. Os peritos inquiridos mostraram reconhecer a importância da dislipidemia aterogénica, o papel preponderante do colesterol de lipoproteínas de baixa densidade (c-LDL) e do colesterol total, excluindo o das lipoproteínas de alta densidade (colesterol não-HDL), na indicac¸ão do risco cardiovascular e na definic¸ão de objetivos terapêuticos, a eleic¸ão das estatinas como fármaco antidislipidémico de primeira linha e a pertinência da sua associac¸ão com o fenofibrato para a reduc¸ão do risco residual. Não obstante, o painel manifestou incerteza no que se refere ao papel dos triglicerídeos e ao valor terapêutico dos fibratos. Tendo como base a evidência disponível na literatura e as opiniões recolhidas neste estudo, a comissão científica elaborou um algoritmo de tratamento com o objetivo de promover a sensibilizac¸ão e adequac¸ão da terapêutica a doentes com dislipidemia aterogénica.
Introduction and aims: Atherogenic dyslipidemia is an important contributor to residual cardi-ovascular (CV) risk, but it is underdiagnosed and undertreated. This study aimed to assess theopinion of Portuguese experts to generate a consensus concerning the diagnosis and treatmentof atherogenic dyslipidemia, as well as to contribute toward standardization of clinical practicein this disorder.Methods: The study consisted in the application of a questionnaire to an expert panel, followinga modified Delphi methodology.Results: The majority (88.4%) of the proposed items were found to be consensual. The expertpanel recognized the importance of the atherogenic dyslipidemia phenotype, the role played bylow-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol as risk markersand therapeutic targets, the choice of statins as first-line lipid-lowering drugs, and the valueof associating statins with fenofibrate as a means to reduce residual CV risk. However, the roleplayed by triglycerides in CV risk and the therapeutic value of fibrates lacked consensus. Takinginto consideration the state of the art and the opinions expressed in this study, the scientificcommittee developed a treatment algorithm aimed to improve the perception and treatmentof atherogenic dyslipidemia.Conclusions: The experts involved in this study were shown to be familiar with the concept andthe importance of atherogenic dyslipidemia. The few situations in which a consensus could notbe found were mainly related to the interpretation and/or relevance of the available evidence.
URI: https://hdl.handle.net/10316/107356
ISSN: 08702551
DOI: 10.1016/j.repc.2019.03.005
Rights: openAccess
Appears in Collections:FMUC Medicina - Artigos em Revistas Nacionais

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