低密度脂蛋白胆固醇目标实现和自我报告的药物坚持:来自JET-LDL注册表的见解
Andrea Raffaele Munafò1, Marco Ferlini2, Ferdinando Varbella3
1Department of Molecular Medicine, University of Pavia, Pavia, Italy; Cardiologia 1, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
The American journal of cardiology
|October 2, 2024
概括
在急性冠状动脉综合征 (ACS) 患者中,低药物坚持率 (28.7%) 是常见的. 对降脂疗法 (LLT) 的不良坚持显著阻碍了在ACS事件后达到目标低密度脂蛋白胆固醇 (LDL-C) 水平.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 目前的指导方针建议急性冠状动脉综合征 (ACS) 患者低密度脂蛋白胆固醇 (LDL-C) <55毫克/100毫升.
- 实现LDL-C目标仍然具有挑战性,因为药物坚持程度低于最佳.
研究的目的:
- 评估在ACS患者的降脂疗法 (LLT) 坚持和LDL-C目标实现之间的关系.
- 为了确定药物坚持对ACS后达到推的LDL-C水平的影响.
主要方法:
- 对JET-低密度脂蛋白 (JET-LDL) 注册表的次分析包括963名ACS患者.
- 在3个月的随访中,使用莫里斯基药物坚持度表 (MMAS) 评估了药物坚持度,将患者分为高 (HA) 和低坚持度 (LA) 组.
- 主要终点是LDL-C从基线减少>50%或水平<55毫克/100毫升在1个月.
主要成果:
- 28.7%的患者报告了较低的坚持 (MMAS <6).
- 主要终点在HA患者中达到了65%,而LA患者中达到了60% (p=0.034).
- 低坚持 (LA) 是未达到主要终点 (OR 0.48,p=0.006) 的独立预测因素.
结论:
- 在ACS患者中,低于最佳的降脂疗法的坚持是普遍存在的.
- 在ACS患者中,较低的药物坚持显著损害了LDL-C目标的实现.
- 改善LLT遵守的策略对于优化ACS中二次预防至关重要.
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