Jain Madhur, Sawant Rahul, Panchal Hitanshu, S Anand, Jena Anupam, Gupta Rahul, Kumar Karthik, Jambunathan Rajagopal, Modi Sunil, Mullasari Ajit, Sinha Nakul, Shetty Kimi, Kawatra Pallavi
Dr Madhu Jain's Clinic, New Delhi, India.
Hridaymitra Cardia Clinic, Pune, India.
Int J Cardiol Cardiovasc Risk Prev. 2023 Sep 16;19:200210. doi: 10.1016/j.ijcrp.2023.200210. eCollection 2023 Dec.
Low-density lipoprotein-cholesterol (LDL-C) is an independent risk factor for atherosclerotic cardiovascular disease (ASCVD) progression. Although lipid lowering therapies remain the cornerstone of secondary ACSVD prevention, there exists residual dyslipidemia. The current study aimed to evaluate the real-world experience related to the treatment patterns and LDL-C control in Indian Acute Coronary Syndrome (ACS) patients.
This was a real-world, descriptive, retrospective, observational, and multicentric study conducted across India. The data was collected for 1 year following the ACS event. The change in the levels of LDL-C from the baseline to the follow-up visits and the control of LDL-C, the change in lipid profile, lipoprotein levels, treatment patterns for lipid-lowering, and tolerability of existing treatments were evaluated.
Overall, 575 patients were included from 11 centers across India. The mean age of the patients was 52.92 years, with male predominance (76.35%). Although there was a significant reduction in the mean levels of LDL-C from the baseline [(122.64 ± 42.01 mg/dl to 74.41 ± 26.45 mg/dl (p < 0.001)], it was observed that despite high-intensity statin therapy, only 20.87% patients managed to achieve target LDL-C of <55 mg/dL and 55.65% were unable to reach LDL-C levels of <70 mg/dl one year after the event. Six patients reported adverse events without treatment discontinuation.
The majority of the patients received high-intensity statins and did not attain target LDL-C levels, suggesting LDL-C control after an ACS event requires management with novel therapies having better efficacy as recommended by international and national guidelines.
低密度脂蛋白胆固醇（LDL-C）是动脉粥样硬化性心血管疾病（ASCVD）进展的独立危险因素。尽管降脂治疗仍然是二级ASCVD预防的基石，但仍存在残余血脂异常。本研究旨在评估印度急性冠状动脉综合征（ACS）患者的治疗模式和LDL-C控制的真实世界经验。
这是一项在印度进行的真实世界、描述性、回顾性、观察性和多中心研究。在ACS事件发生后1年内收集数据。评估从基线到随访时LDL-C水平的变化、LDL-C的控制情况、血脂谱变化、脂蛋白水平、降脂治疗模式以及现有治疗的耐受性。
总体而言，来自印度11个中心的575例患者被纳入研究。患者的平均年龄为52.92岁，男性占主导（76.35%）。尽管从基线开始LDL-C的平均水平有显著降低[（122.64±42.01mg/dl降至74.41±26.45mg/dl（p<0.001）]，但观察到尽管进行了高强度他汀类药物治疗，但事件发生1年后，只有20.87%的患者达到了<55mg/dL 的LDL-C目标，55.65%的患者未能达到<70mg/dl的LDL-C水平。6例患者报告了不良事件，但未停药。
大多数患者接受了高强度他汀类药物治疗，但未达到LDL-C目标水平，这表明ACS事件后的LDL-C控制需要按照国际和国内指南的建议，采用疗效更好的新疗法进行管理。
