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冠心病年轻患者的心血管危险因素控制不充分。

Cardiovascular risk factor control is insufficient in young patients with coronary artery disease.

作者信息

Christiansen Morten Krogh, Jensen Jesper Møller, Brøndberg Anders Krogh, Bøtker Hans Erik, Jensen Henrik Kjærulf

机构信息

Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.

出版信息

Vasc Health Risk Manag. 2016 May 25;12:219-27. doi: 10.2147/VHRM.S106436. eCollection 2016.

Abstract

BACKGROUND

Control of cardiovascular risk factor is important in secondary prevention of coronary artery disease (CAD) but it is unknown whether treatment targets are achieved in young patients. We aimed to examine the prevalence and control of risk factors in this subset of patients.

METHODS

We performed a cross-sectional, single-center study on patients with documented CAD before age 40. All patients treated between 2002 and 2014 were invited to participate at least 6 months after the last coronary intervention. We included 143 patients and recorded the family history of cardiovascular disease, physical activity level, smoking status, body mass index, waist circumference, blood pressure, cholesterol levels, metabolic status, and current medical therapy. Risk factor control and treatment targets were evaluated according to the shared guidelines from the European Society of Cardiology.

RESULTS

The most common insufficiently controlled risk factors were overweight (113 [79.0%]), low-density lipoprotein cholesterol above target (77 [57.9%]), low physical activity level (78 [54.6%]), hypertriglyceridemia (67 [46.9%]), and current smoking (53 [37.1%]). Almost one-half of the patients fulfilled the criteria of metabolic syndrome. The median (interquartile range) number of uncontrolled modifiable risk factors was 2 (2;4) and only seven (4.9%) patients fulfilled all modifiable health measure targets.

CONCLUSION

Among the youngest patients with CAD, there remains a potential to improve the cardiovascular risk profile.

摘要

背景

控制心血管危险因素在冠状动脉疾病(CAD)的二级预防中很重要,但年轻患者是否能达到治疗目标尚不清楚。我们旨在研究这一亚组患者中危险因素的患病率及控制情况。

方法

我们对40岁之前确诊为CAD的患者进行了一项横断面单中心研究。邀请了2002年至2014年间接受治疗的所有患者在最后一次冠状动脉介入治疗至少6个月后参与研究。我们纳入了143例患者,并记录了心血管疾病家族史、身体活动水平、吸烟状况、体重指数、腰围、血压、胆固醇水平、代谢状况和当前的药物治疗情况。根据欧洲心脏病学会的共同指南评估危险因素控制情况和治疗目标。

结果

控制不足最常见的危险因素是超重(113例[79.0%])、低密度脂蛋白胆固醇高于目标值(77例[57.9%])、身体活动水平低(78例[54.6%])、高甘油三酯血症(67例[46.9%])和当前吸烟(53例[37.1%])。几乎一半的患者符合代谢综合征标准。未控制的可改变危险因素的中位数(四分位间距)为2(2;4),只有7例(4.9%)患者达到了所有可改变健康指标的目标。

结论

在最年轻的CAD患者中,改善心血管风险状况仍有潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b36f/4888858/c6f189efe5a4/vhrm-12-219Fig1.jpg

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