Bernardi André, Olandoski Marcia, Erbano Lucas Olandoski, Guarita-Souza Luiz Cesar, Baena Cristina Pellegrino, Faria-Neto José Rocha
Faculdade de Medicina, Pontifícia Universidade Católica do Paraná, Curitiba, PR - Brasil.
Hospital Universitário Evangélico Mackenzie, Curitiba, PR - Brasil.
Arq Bras Cardiol. 2022 May 9;118(6):1018-25. doi: 10.36660/abc.20210328.
Reduction of LDL-cholesterol (LDL-c) levels is the cornerstone in risk reduction, but many high-risk patients are not achieving the recommended lipid goals, even in high-income countries.
To evaluate whether patients seen in the city of Curitiba public health system are reaching LDL-c goals after an acute myocardial infarction (AMI).
This retrospective cohort explored the data of patients admitted with AMI between 2008 and 2015 in public hospitals from the city of Curitiba. In order to evaluate the attainment of the LDL-c target, we have used the last value registered in the database for each patient up to 2016. For those who had at least one LDL-c registered in the year before AMI, percentage of reduction was calculated. The level of significance adopted for statistical analysis was p<0.05.
Of 7,066 patients admitted for AMI, 1,451 were followed up in an out-patient setting and had at least one evaluation of LDL-c. Mean age was 60.8±11.4 years and 35.8%, 35.2%, 21.5%, and 7.4% of patients had LDL-c levels ≥100, 70-99, 50-69 and <50 mg/dL, respectively. Of these, 377 patients also had at least one LDL-c evaluation before the AMI. Mean LDL-c concentrations were 128.0 and 92.2 mg/dL before and after AMI, with a mean reduction of 24.3% (35.7 mg/dL). LDL-c levels were reduced by more than 50% in only 18.3% of the cases.
In the city of Curitiba public health system patients, after myocardial infarction, are not achieving adequate LDL-c levels after AMI.
降低低密度脂蛋白胆固醇（LDL-c）水平是降低风险的基石，但即使在高收入国家，许多高危患者仍未达到推荐的血脂目标。
评估库里蒂巴市公共卫生系统中的患者在急性心肌梗死（AMI）后是否达到LDL-c目标。
这项回顾性队列研究探讨了2008年至2015年在库里蒂巴市公立医院因AMI入院的患者数据。为了评估LDL-c目标的达成情况，我们使用了数据库中截至2016年每位患者的最后记录值。对于那些在AMI前一年至少有一次LDL-c记录的患者，计算降低百分比。统计分析采用的显著性水平为p<0.05。
在7066例因AMI入院的患者中，1451例在门诊接受随访，且至少有一次LDL-c评估。平均年龄为60.8±11.4岁，LDL-c水平≥100、70-99、50-69和<50mg/dL的患者分别占35.8%、35.2%、21.5%和7.4%。其中，377例患者在AMI前也至少有一次LDL-c评估。AMI前后LDL-c平均浓度分别为128.0和92.2mg/dL，平均降低24.3%（35.7mg/dL）。仅18.3%的病例LDL-c水平降低超过50%。
在库里蒂巴市公共卫生系统的患者中，心肌梗死后未达到AMI后足够的LDL-c水平。
