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在阿联酋,急性心肌梗死后 1 年内降脂治疗模式与心血管事件风险的关系。

Lipid lowering therapy patterns and the risk of cardiovascular events in the 1-year after acute myocardial infarction in United Arab Emirates.

机构信息

Amgen Inc., One Amgen Drive, Thousand Oaks, California, United States of America.

Dubai Health Authority, Dubai, United Arab Emirates.

出版信息

PLoS One. 2022 Sep 2;17(9):e0268709. doi: 10.1371/journal.pone.0268709. eCollection 2022.

Abstract

AIM

In United Arab Emirates, cardiovascular disease (CVD) is a leading cause of mortality and 22% of CVD deaths are attributable to acute myocardial infarction (MI). Adherence to guidelines for lipid management is incompletely described in the Middle East. This study aimed to characterize lipid lowering therapy (LLT) patterns and the risk of subsequent cardiovascular events (CVEs) in the first year after MI.

METHODS

This was a retrospective cohort study using the Dubai Real-World Claims Database, including all patients discharged with MI between January 01, 2015 and December 31, 2018, followed-up until December 31, 2019.

RESULTS

In the first year after MI, 8.42% of 4,595 patients included experienced at least one recurrent MI (rate 6.77 events/100 person-years [PYs]), 2.94% had one revascularization (cumulative rate 0.55 events/100 PYs) and 2.66% had one hospitalization due to unstable angina (cumulative rate 5.16 new events/100 PYs). The majority (60.40%) of the patients presented with LDL-C levels ≥ 70 mg/dL after MI. In the first year after MI, 93.45% of the patients received LLT, mainly high-intensity statin (67.79%); with a minority of patients receiving statin + ezetimibe (4.55%), PCSK9i (0.20%) or ezetimibe alone (0.07%).

CONCLUSION

Patients hospitalized with MI in Dubai present an increased risk of CVEs in their first-year post-discharge. Majority of the patients presented with LDL-C levels above 70 mg/dL, which indicates suboptimal lipid control with existing LLT, particularly in high-risk patients.

摘要

目的

在阿拉伯联合酋长国,心血管疾病(CVD)是导致死亡的主要原因,22%的 CVD 死亡归因于急性心肌梗死(MI)。在中东地区,对血脂管理指南的依从性描述并不完整。本研究旨在描述 MI 后第一年降脂治疗(LLT)模式和随后发生心血管事件(CVE)的风险。

方法

这是一项使用迪拜真实世界索赔数据库的回顾性队列研究,纳入了 2015 年 1 月 1 日至 2018 年 12 月 31 日期间出院的所有 MI 患者,随访至 2019 年 12 月 31 日。

结果

MI 后第一年,4595 例患者中有 8.42%(6.77 例/100 人年)至少发生一次再发 MI,2.94%(0.55 例/100 人年)行血运重建,2.66%(5.16 例/100 人年)因不稳定型心绞痛住院。大多数(60.40%)患者 MI 后 LDL-C 水平≥70mg/dL。MI 后第一年,93.45%的患者接受了 LLT,主要是高强度他汀(67.79%);少数患者接受了他汀+依折麦布(4.55%)、PCSK9i(0.20%)或依折麦布单药(0.07%)。

结论

在迪拜因 MI 住院的患者在出院后第一年发生 CVE 的风险增加。大多数患者的 LDL-C 水平高于 70mg/dL,表明现有 LLT 下血脂控制不理想,尤其是在高危患者中。

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Dyslipidaemia in the Middle East: Current status and a call for action.中东地区的血脂异常:现状与行动呼吁。
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