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冠心病患者血脂异常的管理:来自 27 个国家的 ESC-EORP EUROASPIRE V 调查结果。

Management of dyslipidaemia in patients with coronary heart disease: Results from the ESC-EORP EUROASPIRE V survey in 27 countries.

机构信息

Department of Public Health and Primary Care, Ghent University, Belgium.

Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland.

出版信息

Atherosclerosis. 2019 Jun;285:135-146. doi: 10.1016/j.atherosclerosis.2019.03.014. Epub 2019 Apr 24.

DOI:10.1016/j.atherosclerosis.2019.03.014
PMID:31054483
Abstract

BACKGROUND AND AIMS

One of the objectives of the ESC-EORP EUROASPIRE V survey is to determine how well European guidelines on the management of dyslipidaemias are implemented in coronary patients.

METHODS

Standardized methods were used by trained technicians to collect information on 7824 patients from 130 centers in 27 countries, from the medical records and at a visit at least 6 months after hospitalization for a coronary event. All lipid measurements were performed in one central laboratory. Patients were divided into three groups: on high-intensity LDL-C-lowering-drug therapy (LLT), on low or moderate-intensity LLT and on no LLT.

RESULTS

At the time of the visit, almost half of the patients were on a high-intensity LLT. Between hospital discharge and the visit, LLT had been reduced in intensity or interrupted in 20.8% of the patients and had been started or increased in intensity in 11.7%. In those who had interrupted LLT or had reduced the intensity, intolerance to LLT and the advice of their physician were reported as the reason why in 15.8 and 36.8% of the cases, respectively. LDL-C control was better in those on a high-intensity LLT compared to those on low or moderate intensity LLT. LDL-C control was better in men than women and in patients with self-reported diabetes.

CONCLUSIONS

The results of the EUROASPIRE V survey show that most coronary patients have a less than optimal management of LDL-C. More professional strategies are needed, aiming at lifestyle changes and LLT adapted to the need of the individual patient.

摘要

背景和目的

ESC-EORP EUROASPIRE V 调查的目的之一是确定欧洲血脂异常管理指南在冠心病患者中的实施情况。

方法

经过培训的技术人员采用标准化方法,从 27 个国家的 130 个中心的病历和住院至少 6 个月后的就诊记录中收集了 7824 名患者的信息。所有的血脂测量都是在一个中心实验室进行的。患者分为三组:高强度 LDL-C 降低药物治疗(LLT)组、低强度或中强度 LLT 组和无 LLT 组。

结果

在就诊时,近一半的患者正在接受高强度 LLT。在出院至就诊期间,20.8%的患者减少了 LLT 的强度或中断了 LLT,11.7%的患者开始或增加了 LLT 的强度。在中断 LLT 或降低 LLT 强度的患者中,分别有 15.8%和 36.8%的患者报告不耐受 LLT 和医生的建议是中断或降低 LLT 的原因。与低强度或中强度 LLT 相比,高强度 LLT 的 LDL-C 控制更好。与女性相比,男性的 LDL-C 控制更好,且有自我报告糖尿病的患者的 LDL-C 控制更好。

结论

EUROASPIRE V 调查的结果表明,大多数冠心病患者的 LDL-C 管理不理想。需要采取更专业的策略,旨在改变生活方式和根据患者的需求调整 LLT。

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