Hajahmadi Pourrafsanjani Mojgan, Khayati Shal Ebrahim, Khezrpour Sina
Cardiology Department, Urmia University of Medical Sciences, Urmia, 57147-83734, Iran.
High Blood Press Cardiovasc Prev. 2019 Feb;26(1):37-43. doi: 10.1007/s40292-019-00298-5. Epub 2019 Jan 25.
Reducing low-density lipoprotein cholesterol (LDL-C) to target < 100 mg/dL is considered as a critical therapeutic goal after acute coronary syndrome (ACS).
To evaluate the factors associated with reaching or not this LDL-C target after 6 months of statin therapy.
Demographic features and other clinically relevant information from a cohort of patients enrolled from April 3, 2016 through March 20, 2017 were analyzed in the current investigation. All included cases had baseline LDL-C levels ≥ 100 mg/dL. LDL-C levels were determined once again after 6-month of statin therapy for each patient.
Two hundred and thirty two participants were included in the final analysis. One third of patients (33.2%) with ACS with initially elevated LDL-C failed to attain LDL-C goal at 6 months. Spearman correlation test showed that the age, diabetes mellitus, lipid lowering therapy and statin daily dose were among the influential factors associated with LDL-C goal achievement. Furthermore, multiple logistic regression analysis revealed that diabetes mellitus and statin treatment before admission were the only independent predictors of achieving LDL-C goal.
According to our findings, the drug adherence and use of higher intensity as recommended in secondary prevention are needed to increase the achievement of LDL-C treatment targets.
将低密度脂蛋白胆固醇(LDL-C)降至<100mg/dL的目标被认为是急性冠状动脉综合征(ACS)后的关键治疗目标。
评估他汀类药物治疗6个月后达到或未达到该LDL-C目标的相关因素。
在本研究中分析了2016年4月3日至2017年3月20日入组的一组患者的人口统计学特征和其他临床相关信息。所有纳入病例的基线LDL-C水平≥100mg/dL。对每位患者进行他汀类药物治疗6个月后再次测定LDL-C水平。
232名参与者纳入最终分析。最初LDL-C升高的ACS患者中有三分之一(33.2%)在6个月时未达到LDL-C目标。Spearman相关性检验显示,年龄、糖尿病、降脂治疗和他汀类药物每日剂量是与LDL-C目标达成相关的影响因素。此外,多因素logistic回归分析显示,糖尿病和入院前他汀类药物治疗是实现LDL-C目标的唯一独立预测因素。
根据我们的研究结果,需要按照二级预防的建议提高药物依从性并使用更高强度的治疗,以提高LDL-C治疗目标的达成率。