既往有心肌梗死病史患者的血脂水平控制不佳。

Inadequate control of lipid levels in patients with a previous myocardial infarction.

作者信息

Ellis C J, Zambanini A, French J K, Denton M, Johnson R, Patel H, White H D

机构信息

Auckland Hospital.

出版信息

N Z Med J. 1998 Dec 11;111(1079):464-7.

PMID:9972199

Abstract

AIM

To access the current lipid management of late survivors of acute myocardial infarction.

METHODS

A systematic follow-up of all survivors who had previously been screened for enrolment into one of three randomised clinical trials in Auckland was undertaken from December 1995 to January 1997. All contacted survivors were asked to answer a questionnaire regarding their current therapy and were invited to undergo venepuncture for a lipid assay.

RESULTS

Of the 1036 patients with acute myocardial infarction screened for enrolment in the three trials there were 984 (95%) who survived 30 days. At a median of 5.5 years (interquartile range 3.2-8.5) follow-up, 641 (86%) survivors agreed to have a fasting lipid test. The mean total cholesterol level was 5.7 +/- 1.1 mmol/L high density lipoprotein cholesterol 1.1 +/- 0.3 mmol/L, low density lipoprotein cholesterol 3.8 +/- 0.9 mmol/L and triglyceride level 1.9 +/- 1.1 mmol/L. Two hundred and seven (32%) patients were treated with a lipid-modifying agent. Four hundred and forty-five (69%) patients had a cholesterol level > or = 5.2 mmol/L 381 (59%) patients had a level > or = 5.5 mmol/L and 72 (11%) patients had a level > or = 7.0 mmol/L of whom 62 patients were not being treated with a lipid-modifying agent. For the 107 patients with coronary artery bypass grafts, the mean cholesterol level was 5.4 mmol/L and the mean low density lipoprotein cholesterol level was 3.7 +/- 0.9 mmol/L, with 57 (53%) patients not being treated with a "statin" or "fibrate".

CONCLUSION

Lipid management is suboptimal in this high risk population of patients post-infarction and greater efforts need to be made to achieve better control. Diet is frequently inadequate in these patients at high risk and statin therapy is indicated.

摘要

目的

评估急性心肌梗死晚期幸存者当前的血脂管理情况。

方法

1995年12月至1997年1月，对奥克兰先前筛选纳入三项随机临床试验之一的所有幸存者进行了系统随访。所有联系到的幸存者均被要求回答一份关于其当前治疗情况的问卷，并被邀请接受静脉穿刺进行血脂检测。

结果

在筛选纳入三项试验的1036例急性心肌梗死患者中，有984例（95%）存活30天。在中位随访5.5年（四分位间距3.2 - 8.5年）时，641例（86%）幸存者同意进行空腹血脂检测。总胆固醇平均水平为5.7±1.1 mmol/L，高密度脂蛋白胆固醇为1.1±0.3 mmol/L，低密度脂蛋白胆固醇为3.8±0.9 mmol/L，甘油三酯水平为1.9±1.1 mmol/L。207例（32%）患者接受了调脂药物治疗。445例（69%）患者胆固醇水平≥5.2 mmol/L，381例（59%）患者胆固醇水平≥5.5 mmol/L，72例（11%）患者胆固醇水平≥7.0 mmol/L，其中62例患者未接受调脂药物治疗。对于107例接受冠状动脉搭桥术的患者，平均胆固醇水平为5.4 mmol/L，平均低密度脂蛋白胆固醇水平为3.7±0.9 mmol/L，57例（53%）患者未接受“他汀类”或“贝特类”药物治疗。