Bourgeois Elise, Benchalkha Daylale, Brobst Morgane, Herman Fanchon, Molinari Nicolas, Breuker Cyril, Chapet Nicolas, Roubille François, Sultan Ariane
Departments of Endocrinology.
Pharmacy.
Cardiovasc Endocrinol Metab. 2024 Dec 6;14(1):e00320. doi: 10.1097/XCE.0000000000000320. eCollection 2025 Mar.
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.
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.
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.
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.
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.
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。
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。
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。
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。
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。
