{"id":"07d788a3ca2d","type":"article","url":"https://hartvaat.nl/2026/08/15/geautomatiseerde-lipidenmonitoring-en-risicoclassificatie-in-de-huisartspraktijk/","title":"Geautomatiseerde lipidenmonitoring en risicoclassificatie in de huisartspraktijk — real-world studie","title_en":"Longitudinal automated lipid target monitoring integrated into a laboratory-based clinical decision support system: a real-world cardiovascular risk management approach.","category":"cholesterol","category_label":"Cholesterol","professions":["huisarts","internist"],"tags":[],"journal":"Clinica chimica acta; international journal of clinical chemistry","doi":"10.1016/j.cca.2026.121283","source_url":"https://doi.org/10.1016/j.cca.2026.121283","authors":["Jordi Tortosa-Carreres","Mónica Piqueras","Ana Vañó-Bellver","Diana Domingo-Valero","Eugenia Avelino-Hidalgo","Teresa Claramunt-Carbonell","Luís Martínez-Dolz","Begoña Laiz-Marro"],"significance":4,"published":"2026-08-24","source_date":"2026-08-15","image":"","kennis":["https://hartvaat.nl/kennis/lipiden/lpa-meten-wanneer-waarom/","https://hartvaat.nl/kennis/lipiden/ldl-doelwaarden-risicostratificatie/"],"congress":"","summary_en":"A laboratory-integrated clinical decision support system (CDSS) was evaluated for automated cardiovascular risk stratification and longitudinal lipid monitoring across 9,507 primary care patients. Despite high exposure to lipid-lowering therapy, target attainment remained low, particularly in very high and high-risk groups (14.9% and 7.8%, respectively). These real-world findings highlight the need for automated, longitudinal monitoring tools in primary care to bridge the gap between guideline-directed therapy and actual lipid control.","created":"2026-08-17T01:23:00Z","updated":"2026-08-17T01:23:00Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Een laboratoriumgeïntegreerd klinisch beslissingsondersteunend systeem (CDSS) werd geëvalueerd voor de automatische risicoclassificatie en longitudinale lipidenmonitoring bij 9.507 primair-zorgpatiënten. Ondanks een hoog percentage lipidedalverlagende therapie (LLT) bleek het targetattainment laag, met name bij patiënten met een zeer hoog of hoog cardiovasculair risico (respectievelijk 14,9% en 7,8%). De studie toont aan dat geautomatiseerde risicoherschikking en continue monitoring in de huisartspraktijk essentieel zijn om de grote kloof tussen behandeling en lipidencontrole te dichten.","abstract_original":"OBJECTIVES: To evaluate a laboratory-integrated CDSS for lipid monitoring after cardiovascular risk classification. METHODS: An opportunistic laboratory-based CDSS was implemented at Hospital La Fe (València), for primary care lipid requests. Cardiovascular risk was assigned hierarchically by combining direct ESC/EAS guideline-based clinical staging with structured reuse of Lp(a)-adjusted SCORE2-, SCORE2-OP-, or SCORE2-Diabetes-based risk estimations generated by a separate CDSS. The highest risk category prevailed, and new relevant conditions triggered automatic reassessment. LDL-C target attainment was evaluated when TG were < 400 mg/dL, whereas non-HDL-C was used for TG ≥400 mg/dL. Above-target results generated an interpretive report for clinicians. Lipid control, lipid lowering treatment (LLT) exposure, direct staging conditions, age patterns, and longitudinal treatment trajectories were analyzed. RESULTS: During the first 4 months, the CDSS evaluated 9507 eligible requests: 7353 (77.1%) were very high risk, 1881 (20.1%) high risk, 210 (2.2%) moderate risk, and 63 (0.7%) low risk. Lipid target attainment was 14.9%, 7.8%, 25.2%, and 57.1%, respectively. Poor lipid control remained high across age strata, particularly in moderate- to very-high-risk patients. Poor control persisted despite 79.4% recorded LLT exposure in off-target very-high-risk patients. Non-HDL-C assessment was required in 93 patients with TG ≥400 mg/dL, none of whom achieved lipid targets. In the subgroup of 330 patients previously stratified by the separate SCORE2-based CDSS, without direct staging criteria or baseline LLT, 85.2% had baseline poor lipid control; 39.1% initiated LLT during follow-up, and 23.1% subsequently achieved lipid targets. CONCLUSIONS: This CDSS enabled automated risk reassessment and longitudinal lipid target monitoring in primary care."}