Gill Heart and Vascular Institute, 4530University of Kentucky, Lexington, KY, USA.
Samarth Nursing Home and Research Center (Medicine), Kota, Rajasthan, India.
J Cardiovasc Pharmacol Ther. 2020 Nov;25(6):541-547. doi: 10.1177/1074248420933395. Epub 2020 Jun 19.
Patients with sepsis have high rates of major adverse cardiovascular events (MACE) in the literature, but the stratification of those at risk has been limited. Statin indicated groups provides clear criteria for therapy, but the risk of MACE after sepsis based on these groups has never been assessed.
This was a retrospective cohort analysis conducted on adult patients admitted from January 1, 2013, to December 31, 2013, with suspected or confirmed sepsis and data available on statin use. Patients' past medical history; statin use prior, during, or at time of discharge; and occurrence of MACE were recorded from electronic health records.
A total of 321 patients were screened and 265 were found to have data available on statin use. The mean age of the patients was 59 ± 15 years and 47% were female. Overall, 9% were observed to have a MACE at 1 year, with significantly higher rates in those in a statin indicated group (12.2%). On admission, 174 patients were not taking a statin out of whom 52% were in a statin indicated group. Among those in a statin indicated group who survived to hospital discharge, only 10% not on a statin on admission received a statin on discharge, whereas 89% on a statin on admission received a statin on discharge.
There is a high risk of MACE after sepsis especially among those in statin indicated groups with significant clinical inertia in prescribing practices.
文献中脓毒症患者发生主要不良心血管事件（MACE）的比例较高，但风险分层有限。他汀类药物治疗组为治疗提供了明确的标准，但从未根据这些组评估脓毒症后发生 MACE 的风险。
这是一项回顾性队列分析，对 2013 年 1 月 1 日至 12 月 31 日期间因疑似或确诊脓毒症入院且有他汀类药物使用数据的成年患者进行了研究。从电子病历中记录患者的既往病史、在脓毒症发生前、脓毒症期间或出院时使用他汀类药物的情况以及 MACE 的发生情况。
共筛选了 321 名患者，其中 265 名患者有他汀类药物使用数据。患者的平均年龄为 59±15 岁，47%为女性。总体而言，1 年后有 9%的患者发生 MACE，在他汀类药物治疗组中发生率更高（12.2%）。入院时，有 174 名患者未服用他汀类药物，其中 52%处于他汀类药物治疗组。在存活至出院的他汀类药物治疗组患者中，仅 10%入院时未服用他汀类药物的患者在出院时服用了他汀类药物，而入院时服用他汀类药物的患者中有 89%在出院时服用了他汀类药物。
脓毒症后发生 MACE 的风险较高，尤其是在他汀类药物治疗组中，其处方实践存在明显的临床惰性。
