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急性冠状动脉综合征6周后肥胖对血浆低密度脂蛋白水平的影响。

Impact of obesity on low density lipoprotein plasmatic levels 6 weeks after an acute coronary syndrome.

作者信息

Bourgeois Elise, Benchalkha Daylale, Brobst Morgane, Herman Fanchon, Molinari Nicolas, Breuker Cyril, Chapet Nicolas, Roubille François, Sultan Ariane

机构信息

Departments of Endocrinology.

Pharmacy.

出版信息

Cardiovasc Endocrinol Metab. 2024 Dec 6;14(1):e00320. doi: 10.1097/XCE.0000000000000320. eCollection 2025 Mar.

Abstract

INTRODUCTION

Cardiovascular disease is the leading cause of death. One of the main factors is obesity, which is on the rise. LDL levels below 0.55 g/L are recommended after ACS. To date, there are no specific recommendations for obese subjects.

OBJECTIVE

The primary objective was to assess the impact of obesity on LDL-c target attainment 6 weeks after initiation of statin therapy in subjects admitted for ACS. The secondary objectives were to assess the evolution of cholesterol levels and to characterize lipid-lowering treatments.

METHODS

The single-center observational study took place at Montpellier University Hospital and included patients admitted to the ICU for ACS not treated with statins (T0). Biological tests were performed at 6 weeks. At 3 months, a telephone call was made by two pharmacists to collect the results of their biological work-up and any therapeutic modifications.

RESULTS

The results were analyzed on 286 patients. A total of 39.5% were overweight and 22.7% obese. After hospitalization, 95.4% were prescribed statins. At 6 weeks, LDL cholesterol averaged 1.58 mmol/L, lower in subjects with a BMI greater than 30 kg/m (1.32 mmol/L). On average, 49.46% of subjects reached the LDL cholesterol target, with obese subjects achieving a higher rate of 64.9%. There was no significant difference in the prescription of lipid-lowering treatments between the two groups.

CONCLUSION

Despite high-intensity statin prescription, the target was achieved by 67.6% of obese subjects and 44.8% of subjects with a BMI of less than 30 kg/m. This shows that post-SCA management needs to be reinforced for the general population.

摘要

引言

心血管疾病是主要的死亡原因。主要因素之一是肥胖,且肥胖现象正在增加。急性冠状动脉综合征(ACS)后推荐低密度脂蛋白(LDL)水平低于0.55 g/L。迄今为止,对于肥胖患者尚无具体建议。

目的

主要目的是评估肥胖对因ACS入院患者开始他汀类药物治疗6周后LDL-c目标达成情况的影响。次要目的是评估胆固醇水平的变化并对降脂治疗进行特征描述。

方法

这项单中心观察性研究在蒙彼利埃大学医院进行,纳入未接受他汀类药物治疗(T0)的因ACS入住重症监护病房(ICU)的患者。在6周时进行生物学检测。3个月时,两名药剂师通过电话收集其生物学检查结果及任何治疗调整情况。

结果

对286例患者的结果进行了分析。共有39.5%的患者超重,22.7%的患者肥胖。住院后,95.4%的患者被处方他汀类药物。6周时,LDL胆固醇平均为1.58 mmol/L,在体重指数(BMI)大于30 kg/m²的患者中较低(1.32 mmol/L)。平均而言,49.46%的患者达到了LDL胆固醇目标,肥胖患者的达标率更高,为64.9%。两组之间降脂治疗的处方情况无显著差异。

结论

尽管高强度处方他汀类药物,但67.6%的肥胖患者和44.8%的BMI小于30 kg/m²的患者达到了目标。这表明对于普通人群,ACS后的管理需要加强。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37ab/11627480/9a402c641e5b/xce-14-e00320-g001.jpg

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