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Filippi A, Tragni E, Bignamini AA, Sessa E, Merlini G, Brignoli O, Mazzaglia G, Catapano A. Cholesterol control in Stroke
prevention in Italy: a cross-sectional study in family practice. Eur J Cardiovasc Prev Rehabil 2005; 12(2):159-163
ABSTRACT. BACKGROUND: Stroke represents worldwide the second and seventh cause of death and invalidity,
respectively. Patients with ischaemic stroke or transitory ischaemic attack (TIA) are at high risk of recurrence, therefore
requiring intensive treatment. Hypercholesterolaemia is a modifiable risk factor for stroke. The general practitioners
attitude towards detection and treatment of dyslipidaemia among patients with stroke or TIA in Italy is unknown; we
therefore aimed to address this issue taking advantage of the database of The Italian College of General Practitioners.
METHODS: Prevalence of the monitored factors (lipid levels, statin prescription, and lipid level control with hypolipidaemic
agents prescription) were analysed on a patient population of 465 061. RESULTS: A total of 2555 (49% women and
51% men) patients with a diagnosis of stroke and 2755 patients (52% women and 48% men) with a diagnosis of
TIA were included in the study. Total plasma cholesterol (TC) was reported in more than 60% of the patients and low-
density lipoprotein cholesterol (LDLc) and high-density lipoprotein cholesterol (HDLc) in less than half. Total plasma
cholesterol and LDLc were controlled in 70.3 and 72.8% of the patients, respectively. The percentage of controlled
patients decreased to 64% when both LDLc and TC were considered. Statins and fibrates were prescribed in a small
proportion of patients (16.9 and 3.5%, respectively). An acceptable control of blood lipids was achieved in a majority of
those patients (60.2%). However a relatively large number of patients (646) with high plasma lipids remained untreated.
CONCLUSIONS: Monitoring and intervention strategies on plasma lipid levels in patients with a diagnosis of stroke or
TIA need to be improved.
Filippi A, Vannuzzo D, Bignamini AA, Sessa E, Brignoli O, Mazzaglia G. Computerized general practice database
provide quick and cost-effective information on the prevalence of angina pectoris.
Ital Heart J. 2005;6(1):49-51
ABSTRACT. BACKGROUND: The aim of this study was to compare the prevalence of angina pectoris (AP) using self-
reported information and primary care databases. METHODS: A comparison between the prevalence of AP in 730,586
subjects from the Health Search Database (HSD) and 119,799 individuals from a Health Interview Survey (HIS) was
performed. The age-specific prevalence was calculated by dividing the detected cases by the total number of individuals
in each age group. The age-standardized prevalence was estimated by direct standardization performed using the
Italian standard population. RESULTS: The HSD reported a higher crude prevalence of AP than the HIS, both in males
(1374/100,000 vs 1006/100,000) and females (1449/100,000 vs 1007/100,000). In the HSD the age-specific prevalence
was lower for patients aged <65 years, whilst higher estimates were reported for older patients. Age standardization
slightly reduced the prevalence in both samples, although the HSD always reported higher estimates. CONCLUSIONS:
Prescription data from general practice databases may be a valid, simple, and cost-effective method to evaluate and
serially monitor the prevalence of AP.
Sacchetti E, Turrina C, Parrinello G, Brignoli O, Stefanini G, Mazzaglia G. Incidence of diabetes in a general practice
population: a database cohort study on the relationship with haloperidol, olanzapine, risperidone or
quetiapine exposure.
Int Clin Psychopharmacol 2005 ; 20(1):33-37
ABSTRACT. The present study aimed to estimate the incidence of diabetes in general practice patients who were
treated with haloperidol, olanzapine, risperidone or quetiapine monotherapy and in subjects who were not exposed to
antipsychotics. The design was a retrospective, up to 2 years, cohort study, with age-, sex- and length of observation-
matching between subjects who were exposed and not exposed to antipsychotic drugs. Data were taken from the
Health Search database, which contains information from 550 Italian general practitioners. Participants comprised
2,071 subjects taking haloperidol, 266 taking olanzapine, 567 taking risperidone and 109 taking quetiapine, in addition
to 6,026 age- and sex-matched subjects who were not using antipsychotic drugs during the period of observation.
Inclusion was limited to initially non-diabetic and antipsychotic drug-free individuals. The main outcome measure was the
incidence of drug-treated diabetes. After age and sex correction by Cox regression analysis, the four groups treated with
antipsychotics significantly differed from untreated subjects in hazard ratios for diabetes. The ratios for the haloperidol,
olanzapine, risperidone and quetiapine groups were 12.4 (95% confidence interval 6.3-24.5), 20.4 (6.9-60.3), 18.7
(8.2-42.8) and 33.7 (9.2-123.6), respectively, with no significant differences when compared to each other.