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急性冠状动脉综合征中的血脂谱、家族性高胆固醇血症患病率及2年心血管结局评估:一项回顾性队列的真实世界数据

[Lipid profile, familial hypercholesterolemia prevalence, and 2-year cardiovascular outcome assessment in acute coronary syndrome: Real-life data of a retrospective cohort].

作者信息

Kayikcioglu Meral, Alan Bahadir, Payzın Serdar, Can Levent Hürkan

机构信息

Ege University Medical School, Department Of Cardiology, Izmir.

Okan University Medical School, Department Of Cardiology, Istanbul.

出版信息

Turk Kardiyol Dern Ars. 2019 Sep;47(6):476-486. doi: 10.5543/tkda.2019.07360.

Abstract

OBJECTIVE

The aim of this retrospective study based on real-life data was to evaluate the lipid profile and demographic, clinical, and laboratory features of patients with acute coronary syndrome (ACS) at a tertiary center and to examine the mortality rate.

METHODS

Information including endpoint data for at least 2 years following the index ACS event was retrieved from hospital records. Patients without sufficient follow-up data were called by phone. Modified Dutch Lipid Clinic Network criteria were used to identify the presence of familial hypercholesterolemia (FH). Factors affecting mortality in the 2-year follow-up period were evaluated using Cox regression analysis.

RESULTS

A total of 985 ACS patients (215 females) between 21 and 93 years of age were included. The females were older and had a lower smoking rate than the males. In females, the history of obesity and hypertension, the diabetes rate, and the thyroid-stimulating hormone level were higher than those of the males. In 95.6% of the patients, lipid parameters were measured upon hospital admission. No significant difference in dyslipidemia frequency was observed between genders. The frequency of FH was 7.6%. The rate of lipid-lowering drug use was <20% at admission, >90% at discharge, and decreased to 50% in the follow-up period. The mortality rate was 3.8% in the in-hospital period and 8.1% during the 2 years of follow-up.

CONCLUSION

The mortality rate in ACS patients was 3.8% in the in-hospital period and 8.1% in the 2-year follow-up period. The frequency of hypercholesterolemia was 89.5% and the rate of lipid-lowering drug use was insufficient. Secondary prevention after ACS was not adequately employed even at a tertiary center. The FH frequency was 7.6% and those with FH were observed to have ACS at a younger age than those without.

摘要

目的

这项基于真实生活数据的回顾性研究旨在评估一家三级中心急性冠状动脉综合征(ACS)患者的血脂谱以及人口统计学、临床和实验室特征,并考察死亡率。

方法

从医院记录中检索包括ACS事件发生后至少2年的终点数据在内的信息。对没有足够随访数据的患者进行电话随访。采用改良的荷兰脂质诊所网络标准来确定家族性高胆固醇血症(FH)的存在。使用Cox回归分析评估2年随访期内影响死亡率的因素。

结果

共纳入985例年龄在21至93岁之间的ACS患者(215例女性)。女性年龄较大,吸烟率低于男性。女性的肥胖和高血压病史、糖尿病发生率以及促甲状腺激素水平高于男性。95.6%的患者在入院时进行了血脂参数检测。血脂异常发生率在性别之间未观察到显著差异。FH的发生率为7.6%。入院时降脂药物使用率<20%,出院时>90%,随访期降至50%。住院期间死亡率为3.8%,2年随访期间为8.1%。

结论

ACS患者住院期间死亡率为3.8%,2年随访期内为8.1%。高胆固醇血症发生率为89.5%,降脂药物使用率不足。即使在三级中心,ACS后的二级预防也未得到充分应用。FH发生率为7.6%,观察发现FH患者发生ACS的年龄比非FH患者更小。

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