1 Department of Cardiology, National University Heart Centre, Singapore.
2 Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Eur J Prev Cardiol. 2018 Dec;25(18):1950-1963. doi: 10.1177/2047487318798927. Epub 2018 Sep 10.
As mortality due to cardiovascular disease increases throughout the world, accurate data on risk factors such as hyperlipidemia are required. This is lacking in the Asia-Pacific region.
The observational Dyslipidemia International Study (DYSIS) II was established to quantify the extent of hyperlipidemia in adults with acute and stable coronary heart disease globally.
Patients with stable coronary heart disease or hospitalised with an acute coronary syndrome were enrolled across nine Asia-Pacific countries from July 2013 to October 2014. Lipid-lowering therapy and low-density lipoprotein cholesterol target attainment (<70 mg/dL) were assessed. The acute coronary syndrome cohort was followed up 4 months post-discharge.
Of the 4592 patients enrolled, 2794 had stable coronary heart disease and 1798 were admitted with an acute coronary syndrome. In the coronary heart disease cohort, the mean low-density lipoprotein cholesterol level was 86.9 mg/dL, with 91.7% using lipid-lowering therapy and 31% achieving low-density lipoprotein cholesterol of less than 70 mg/dL. In the acute coronary syndrome cohort at admission, the corresponding values were 103.2 mg/dL, 63.4% and 23.0%, respectively. Target attainment was significantly higher in lipid-lowering therapy-treated than non-treated patients in each cohort (32.6% vs. 12.9% and 31.1% vs. 9.0%, respectively). Mean atorvastatin-equivalent dosages were low (20 ± 15 and 22 ± 18 mg/day, respectively), with little use of non-statin adjuvants (13.0% and 6.8%, respectively). Low-density lipoprotein cholesterol target attainment had improved by follow-up for the acute coronary syndrome patients, but remained low (41.7%).
Many patients in Asia at very high risk of recurrent cardiovascular events had a low-density lipoprotein cholesterol level above the recommended target. Although lipid-lowering therapy was common, it was not used to its full potential.
随着心血管疾病导致的死亡率在全球范围内上升，需要准确掌握高血脂等风险因素的数据。而在亚太地区，这方面的数据非常缺乏。
观察性血脂异常国际研究（DYSIS）II 旨在量化全球急性和稳定型冠心病成人血脂异常的严重程度。
2013 年 7 月至 2014 年 10 月，在 9 个亚太国家招募稳定型冠心病或因急性冠脉综合征住院的患者。评估降脂治疗和低密度脂蛋白胆固醇目标达标情况（＜70mg/dL）。急性冠脉综合征队列在出院后 4 个月进行随访。
在 4592 名入组患者中，2794 例患有稳定型冠心病，1798 例因急性冠脉综合征入院。在冠心病队列中，平均低密度脂蛋白胆固醇水平为 86.9mg/dL，91.7%的患者接受了降脂治疗，31%的患者达到了低密度脂蛋白胆固醇＜70mg/dL。在急性冠脉综合征入院时的队列中，相应的值分别为 103.2mg/dL、63.4%和 23.0%。在每个队列中，降脂治疗组的目标达标率显著高于未治疗组（分别为 32.6%比 12.9%和 31.1%比 9.0%）。阿托伐他汀等效剂量平均值较低（分别为 20±15 和 22±18mg/天），而非他汀类辅助药物的使用较少（分别为 13.0%和 6.8%）。急性冠脉综合征患者的随访低密度脂蛋白胆固醇目标达标率有所提高，但仍较低（41.7%）。
在亚太地区，许多处于极高心血管事件复发风险的患者的低密度脂蛋白胆固醇水平高于推荐目标。尽管降脂治疗很常见，但并未充分发挥作用。
