Sridevi C, Malani Susheel, Chaudhary Prakash H, Nalawade Digvijay D, Shokeen Ankit
Cardiology, Dr. D. Y. Patil Medical College, Hospital, and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.
Internal Medicine, Dr. D. Y. Patil Medical College, Hospital, and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.
Cureus. 2024 Oct 20;16(10):e71942. doi: 10.7759/cureus.71942. eCollection 2024 Oct.
Lipid control is crucial in managing coronary artery disease (CAD) to reduce cardiovascular risk. This study aimed to evaluate the effectiveness of lipid-lowering therapy, particularly statins, in achieving target lipid levels in patients with CAD.
This single-center, retrospective, observational study was conducted at the Cardiology Outpatient Department of Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharastra, India. A sample size of 72 patients was included in this study. Adult patients receiving treatment for acute coronary syndrome (ACS), chronic stable angina (CSA), or unstable angina (UA) were included. Exclusion criteria were comorbidities affecting clinical decisions, HIV-positive status, pregnancy, or breastfeeding. Data on lipid profiles, including low-density lipoprotein (LDL) cholesterol (LDL-C), were collected, with LDL-C calculated using the Friedewald equation or measured directly. The primary outcome was the proportion of patients achieving LDL-C targets as per the 2019 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guidelines. Statistical analysis was performed using chi-square tests, with significance set at p < 0.05.
Of the enrolled patients, a substantial proportion did not achieve target LDL-C levels, with LDL-C remaining above the recommended thresholds in a significant number of patients. Despite ongoing statin therapy, lipid control was suboptimal in many cases, particularly among those with elevated LDL-C levels. A detailed analysis of lipid profiles and the achievement of target levels was done, highlighting areas where current treatment strategies may fall short.
The study reveals that a significant number of patients with CAD on statin therapy do not achieve optimal lipid control, particularly in LDL-C management. This underscores the need for more aggressive or tailored lipid-lowering strategies to reduce residual cardiovascular risk in this high-risk population. Further studies are needed to explore the factors contributing to suboptimal lipid control and to develop interventions that can enhance the effectiveness of current therapies.
脂质控制对于管理冠状动脉疾病(CAD)以降低心血管风险至关重要。本研究旨在评估降脂治疗,特别是他汀类药物,在使CAD患者达到目标脂质水平方面的有效性。
本单中心、回顾性、观察性研究在印度马哈拉施特拉邦浦那市D.Y.帕蒂尔医学院、医院及研究中心的心脏病门诊进行。本研究纳入了72例患者。纳入接受急性冠状动脉综合征(ACS)、慢性稳定型心绞痛(CSA)或不稳定型心绞痛(UA)治疗的成年患者。排除标准为影响临床决策的合并症、HIV阳性状态、妊娠或哺乳期。收集包括低密度脂蛋白(LDL)胆固醇(LDL-C)在内的脂质谱数据,LDL-C使用Friedewald方程计算或直接测量。主要结局是根据2019年欧洲心脏病学会(ESC)/欧洲动脉粥样硬化学会(EAS)指南达到LDL-C目标的患者比例。使用卡方检验进行统计分析,显著性设定为p<0.05。
在纳入的患者中,相当大比例的患者未达到LDL-C目标水平,大量患者的LDL-C仍高于推荐阈值。尽管持续进行他汀类药物治疗,但在许多情况下脂质控制仍不理想,尤其是在LDL-C水平升高的患者中。对脂质谱和目标水平的达成情况进行了详细分析,突出了当前治疗策略可能不足的领域。
该研究表明,大量接受他汀类药物治疗的CAD患者未实现最佳脂质控制,尤其是在LDL-C管理方面。这强调了需要更积极或量身定制的降脂策略,以降低这一高危人群的残余心血管风险。需要进一步研究以探索导致脂质控制不理想的因素,并开发能够提高当前治疗效果的干预措施。