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急性冠状动脉综合征患者低密度脂蛋白胆固醇治疗目标未达标的相关危险因素:一项纵向单中心研究

Risk Factors Associated with Failure to Achieve the Low Density Lipoprotein Cholesterol Therapeutic Target in Patients with Acute Coronary Syndrome: A Longitudinal, Single Centre Investigation.

作者信息

Hajahmadi Pourrafsanjani Mojgan, Khayati Shal Ebrahim, Khezrpour Sina

机构信息

Cardiology Department, Urmia University of Medical Sciences, Urmia, 57147-83734, Iran.

出版信息

High Blood Press Cardiovasc Prev. 2019 Feb;26(1):37-43. doi: 10.1007/s40292-019-00298-5. Epub 2019 Jan 25.

Abstract

INTRODUCTION

Reducing low-density lipoprotein cholesterol (LDL-C) to target < 100 mg/dL is considered as a critical therapeutic goal after acute coronary syndrome (ACS).

AIM

To evaluate the factors associated with reaching or not this LDL-C target after 6 months of statin therapy.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

摘要

引言

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。

目的

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。

方法

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。

结果

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。

结论

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。

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