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急性冠脉事件会影响德国的血脂管理及胆固醇目标达成情况吗?:血脂异常国际研究II的结果

Do acute coronary events affect lipid management and cholesterol goal attainment in Germany? : Results from the Dyslipidemia International study II.

作者信息

Gitt Anselm K, Rieber Johannes, Hambrecht Rainer, Brachmann Johannes, Graf Kristof, Horack Martin, Karmann Barbara, Vyas Ami, Lautsch Dominik, Ambegaonkar Baishali, Brudi Philippe

机构信息

Herzzentrum Ludwigshafen, Ludwigshafen, Germany.

Stiftung IHF-Institut für Herzinfarktforschung Ludwigshafen, Bremser Str. 79, 67117, Ludwigshafen, Germany.

出版信息

Wien Klin Wochenschr. 2018 Dec;130(23-24):707-715. doi: 10.1007/s00508-018-1375-3. Epub 2018 Sep 3.

Abstract

OBJECTIVE

To document utilization of lipid-lowering therapy, attainment of low-density lipoprotein cholesterol target values, and cardiovascular outcomes in patients hospitalized for acute coronary syndrome in Germany.

METHODS

The Dyslipidemia International Study II was a multicenter, observational study of the prevalence of dyslipidemia and lipid target value attainment in patients surviving any acute coronary syndrome event. Among patients on lipid-lowering therapy for ≥3 months, use of lipid-lowering therapy and lipid profiles were assessed at admission and again at 120 ± 15 days after admission (the follow-up time point). Multivariate logistic regression was used to identify variables predictive of low-density lipoprotein cholesterol target value attainment in patients using lipid-lowering therapy.

RESULTS

A total of 461 patients hospitalized for acute coronary syndrome were identified, 270 (58.6%) of whom were on lipid-lowering therapy at admission. Among patients on lipid-lowering therapy, 90.7% and 85.9% were receiving statin monotherapy at admission and follow-up, respectively. Mean (SD) low-density lipoprotein cholesterol levels in patients on lipid-lowering therapy were 101 (40) mg/dl and 95 (30) mg/dl at admission and follow-up, respectively. In patients with data at both admission and follow-up (n = 61), low-density lipoprotein cholesterol target value attainment rates were the same (19.7%) at both time points. Smoking was associated with a 77% lower likelihood of attaining the low-density lipoprotein cholesterol target value.

CONCLUSION

Hospitalization for an acute event does not greatly alter lipid management in acute coronary syndrome patients in Germany. Both lipid-lowering therapy doses and rates of low-density lipoprotein cholesterol target value attainment remained essentially the same several months after the event.

摘要

目的

记录德国急性冠状动脉综合征住院患者的降脂治疗使用情况、低密度脂蛋白胆固醇目标值的达成情况以及心血管结局。

方法

血脂异常国际研究II是一项多中心观察性研究,旨在调查任何急性冠状动脉综合征事件存活患者的血脂异常患病率和血脂目标值达成情况。在接受降脂治疗≥3个月的患者中,于入院时及入院后120±15天(随访时间点)再次评估降脂治疗的使用情况和血脂谱。采用多变量逻辑回归分析确定接受降脂治疗患者中低密度脂蛋白胆固醇目标值达成的预测变量。

结果

共纳入461例急性冠状动脉综合征住院患者,其中270例(58.6%)入院时接受降脂治疗。在接受降脂治疗的患者中,入院时和随访时分别有90.7%和85.9%接受他汀类单药治疗。接受降脂治疗患者的平均(标准差)低密度脂蛋白胆固醇水平在入院时和随访时分别为101(40)mg/dl和95(30)mg/dl。在入院和随访时均有数据的患者(n = 61)中,两个时间点的低密度脂蛋白胆固醇目标值达成率相同(19.7%)。吸烟与低密度脂蛋白胆固醇目标值达成可能性降低7

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e946/6290720/1a3ff949d400/508_2018_1375_Fig1_HTML.jpg

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