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冠心病患者实现理想血脂目标的性别差异。

Gender differences in achieving optimal lipid goals in patients with coronary artery disease.

机构信息

Departments of Medicine and Cardiology, University of Pennsylvania Health System, Pennsylvania Hospital, Philadelphia, Pennsylvania.

Biostatistics Analysis Center, University of Pennsylvania, Philadelphia, Pennsylvania.

出版信息

Am J Cardiol. 2014 May 15;113(10):1611-5. doi: 10.1016/j.amjcard.2014.02.018. Epub 2014 Mar 1.

Abstract

To investigate gender differences in lipid goal attainment, we conducted a retrospective analysis of outpatient electronic health records from a large cardiology practice from September 2008 to September 2009. The most recent lipid profile and lipid-lowering medications and doses were extracted from electronic medical record. We identified 9,950 patients with coronary artery disease of whom 3,366 (34%) were women. Women were less likely to achieve a low-density lipoprotein (LDL) cholesterol goal of <70 mg/dl compared with men (30.6% vs 38.4%, p <0.001) and less likely to achieve a non-high-density lipoprotein cholesterol goal of <100 mg/dl (37.1% vs 48.2%, p <0.001). Irrespective of age, women were less likely to achieve their LDL cholesterol goals. Compared with men, women were more likely to be on no statin (16.9% vs 11.6%, p <0.001) or any lipid-lowering therapy (12.8% vs 7.8%, p <0.001) and less likely to be on high-potency statin (14.9% vs 18.0%, p <0.001) or combination therapy (22.2% vs 30.1%, p <0.001). There exists a major difference in the use of lipid-lowering therapy between men and women with coronary artery disease. In conclusion, women with coronary artery disease are prescribed insufficient doses of statins and combination lipid-lowering therapy and are less likely to achieve their optimal LDL and non-high-density lipoprotein cholesterol goals.

摘要

为了研究血脂目标达标情况的性别差异,我们对一家大型心脏病学诊所 2008 年 9 月至 2009 年 9 月的门诊电子健康记录进行了回顾性分析。从电子病历中提取了最近的血脂谱和降脂药物及剂量。我们确定了 9950 例冠心病患者,其中 3366 例(34%)为女性。与男性相比,女性实现低密度脂蛋白(LDL)胆固醇<70mg/dl 目标的可能性更小(30.6%比 38.4%,p<0.001),实现非高密度脂蛋白胆固醇<100mg/dl 目标的可能性更小(37.1%比 48.2%,p<0.001)。无论年龄大小,女性实现 LDL 胆固醇目标的可能性均较小。与男性相比,女性更有可能未服用他汀类药物(16.9%比 11.6%,p<0.001)或任何降脂治疗(12.8%比 7.8%,p<0.001),而更有可能服用低强度他汀类药物(14.9%比 18.0%,p<0.001)或联合降脂治疗(22.2%比 30.1%,p<0.001)。冠心病患者中降脂治疗的使用存在显著的性别差异。总之,患有冠心病的女性接受的他汀类药物剂量不足,联合降脂治疗的应用也不足,且实现 LDL 和非高密度脂蛋白胆固醇最佳目标的可能性更小。

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