Rondina Matthew T, Zebrack James S
The Heart Center, 1160 East 3900 South, Suite 2000, Salt Lake City, UT 84124, USA.
Prev Cardiol. 2005 Winter;8(1):18-22. doi: 10.1111/j.1520-037x.2005.3757.x.
National Cholesterol Education Program (NCEP) guidelines recommend low-density lipoprotein cholesterol (LDL-C) levels <100 mg/dL for patients with coronary artery disease (CAD) and lipid-lowering therapy if LDL-C remains >100-130 mg/dL after dietary intervention. Studies consistently report that the majority of CAD patients do not achieve NCEP goals in clinical practice; we sought to determine if our practice fared better. We performed a retrospective chart review of 600 CAD patients followed by cardiologists. The mean age was 69, and 66% of patients were male. Of persons with a cardiology clinic lipid profile (60%), most (76%) achieved an LDL-C <100 mg/dL; however, only 61% were treated to the NCEP secondary goal of non-HDL-C <130 mg/dL. Of patients not at an LDL-C goal, 81% were on lipid-lowering therapy, but only 18% were on maximal statin doses and 6% on combination therapy. We concluded that the majority of CAD patients have had recent lipid measurements and are treated according to NCEP guidelines, but many patients remain on suboptimal therapy.
美国国家胆固醇教育计划（NCEP）指南建议，冠状动脉疾病（CAD）患者的低密度脂蛋白胆固醇（LDL-C）水平应低于100mg/dL，且在饮食干预后若LDL-C仍高于100 - 130mg/dL，则需进行降脂治疗。研究一致报道，在临床实践中，大多数CAD患者未达到NCEP目标；我们试图确定我们的治疗情况是否更好。我们对600例由心脏病专家随访的CAD患者进行了回顾性病历审查。平均年龄为69岁，66%的患者为男性。在有心脏病门诊血脂检查结果的患者中（占60%），大多数（76%）的LDL-C低于100mg/dL；然而，只有61%的患者接受治疗后达到了非HDL-C低于130mg/dL的NCEP二级目标。在未达到LDL-C目标的患者中，81%正在接受降脂治疗，但只有18%的患者使用了最大他汀剂量，6%的患者采用了联合治疗。我们得出结论，大多数CAD患者近期进行了血脂检测并按照NCEP指南接受治疗，但许多患者的治疗仍未达到最佳水平。
