Setny Małgorzata, Jankowski Piotr, Krzykwa Agnieszka, Kamiński Karol A, Gąsior Zbigniew, Haberka Maciej, Czarnecka Danuta, Pająk Andrzej, Kozieł Paweł, Szóstak-Janiak Karolina, Sawicka Emilia, Stachurska Zofia, Kosior Dariusz A
Clinical Cardiology Center, Central Research Hospital the Ministry of The Interior and Administration, 02-507 Warsaw, Poland.
I Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, 31-008 Kraków, Poland.
J Clin Med. 2021 Jun 11;10(12):2594. doi: 10.3390/jcm10122594.
Cardiovascular diseases (CVDs) are the leading cause of death in Poland. Starting from 1992, a gradual decrease in mortality due to CVDs has been observed, which is less noticeable in women. Following this notion, we assessed sex differences in the implementation of ESC recommendations regarding lipid control and the use of statins as part of secondary CVDs prevention in 1236 patients with acute coronary syndrome or elective coronary revascularization within the last 6-24 months. During hospitalization women had more frequently abnormal TC levels than men ( = 0.035), with overall higher TC levels ( = 0.009) and lower HDL-C levels ( = 0.035). In the oldest group, they also had more frequently elevated LDL-C levels ( = 0.033). Similar relationships were found during the follow-up visit. In addition, women less often achieved the secondary lipid therapeutic goal for non-HDL-C ( = 0.009). At discharge from hospital women were less frequently prescribed statins ( = 0.001), which included high-intensity statins ( = 0.002). At the follow-up visit the use of high-intensity statins was still less frequent in women ( = 0.02). We conclude that women generally have less optimal lipid profiles than men and are less likely to receive high-intensity statins. There is a need for more organized care focused on the management of risk factors.
心血管疾病（CVDs）是波兰的主要死因。自1992年以来，已观察到CVDs导致的死亡率逐渐下降，这在女性中不太明显。基于这一观点，我们评估了1236例在过去6至24个月内患有急性冠状动脉综合征或接受择期冠状动脉血运重建的患者在实施欧洲心脏病学会（ESC）关于血脂控制和使用他汀类药物作为二级CVDs预防措施方面的性别差异。住院期间，女性TC水平异常的频率高于男性（P = 0.035），总体TC水平更高（P = 0.009），HDL-C水平更低（P = 0.035）。在年龄最大的组中，她们LDL-C水平升高的频率也更高（P = 0.033）。在随访期间也发现了类似的关系。此外，女性达到非HDL-C二级血脂治疗目标的频率较低（P = 0.009）。出院时，女性接受他汀类药物治疗的频率较低（P = 0.001），其中包括高强度他汀类药物（P = 0.002）。在随访时，女性使用高强度他汀类药物的频率仍然较低（P = 0.02）。我们得出结论，女性的血脂谱总体上不如男性理想，接受高强度他汀类药物治疗的可能性也较小。需要更有组织的护理来关注危险因素的管理。
