对患有症状下肢外周动脉疾病的患者进行最佳医疗疗的回顾性分析:一项法国观察性研究
Camille de Kermenguy1,2, Anne Durand1,2, Quentin Tollenaere1,2
1Vascular Medicine Unit, CHU Rennes, 2 Rue Henri Le Guilloux, Rennes, 35033, France.
BMC cardiovascular disorders
|November 1, 2024
概括
大多数下肢动脉疾病 (LEAD) 患者无法达到LDL-胆固醇 (LDLc) 目标,医疗治疗的患病率低于最佳. 患有血管外科病史的患者,尽管进行了一致的随访,但没有改善管理.
科学领域:
- 心血管医学 心血管医学
- 血管外科 血管外科
- 药理学 药理学是指药理学的学科.
背景情况:
- 症状的下肢动脉疾病 (LEAD) 管理需要最佳的脂质控制 (LDL-胆固醇 [LDLc]) 和医疗治疗.
- 达到LDLc<0.55g/L和最佳医疗治疗的LEAD患者的患病率尚未确立.
- 最佳的医疗治疗包括三重疗法:抗血小板,他类药物和ACE抑制剂/ARB.
研究的目的:
- 为了确定LEAD患者达到LDLc<0.55g/L的患病率.
- 评估LEAD患者最佳医疗治疗的流行率.
- 为了比较LEAD患者与没有血管外科手术史之间的管理策略.
- 评估适用于新型降脂疗法的资格 (FOURIER和REDUCE-IT标准).
主要方法:
- 单中心回顾性研究设计.
- 使用数字和百分比计算的患病率.
- 在之前进行了血管外科手术和没有进行过血管外科手术的LEAD患者之间对管理的比较.
- 对FOURIER (evolocumab) 和REDUCE-IT (icosapent ethyl) 研究的患者资格的计算.
主要成果:
- 只有12.4%的LEAD患者达到LDLc<0.55g/L.
- 50.7%的患者接受了最佳的医疗治疗.
- 在患有 (10.6%) 和没有 (13.6%) 血管外科手术史的患者之间,LDLc目标的实现没有显著差异.
- 46.0%的患者有资格接受evolocumab和8.4%的患者接受icosapent乙烯.
结论:
- 绝大多数下肢动脉疾病患者没有达到LDL胆固醇的目标.
- 有血管外科手术史的LEAD患者没有表现出优异的管理结果.
- 尽管进行了更一致的随访,但血管外科手术史与LEAD患者的更好的医疗管理没有相关性.
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