在非致命的急性冠状动脉综合征后降脂的处方模式:一项回顾性队列研究
Cristina Gavina1,2,3, Daniel Seabra Carvalho1, Marta Afonso-Silva4
1Cardiology Department, Hospital Pedro Hispano-Unidade Local de Saúde Matosinhos, Matosinhos, Portugal.
大多数急性冠状动脉综合征 (ACS) 患者在开始或加强降脂疗法 (LLT) 一年后无法实现LDL-C目标. 这突显了心血管事件预防指导方针实施中的差距.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 药理学 药理学是指药理学的学科.
背景情况:
- 急性动脉样硬化心血管事件需要高强度降脂疗法 (LLT) 来减轻复发风险.
- 降脂疗法 (LLT) 和低密度脂蛋白胆固醇 (LDL-C) 水平是急性冠状动脉综合征 (ACS) 后的关键水平.
研究的目的:
- 在非致命的ACS事件后检查LLT处方模式.
- 在ACS后评估LDL-C水平的变化.
- 为了确定推的LDL-C目标的实现率.
主要方法:
- 从2015-2023年使用电子健康记录 (EHR) 的回顾性队列研究.
- 纳入标准:40至80岁的非致命ACS的成年人,先前的全科医院访问和一年的随访.
- 根据性别,年龄 (≥65岁) 和一年后的LDL-C控制进行了分分析.
主要成果:
- 只有11.3%的男性和8.5%的女性在ACS后一年达到LDL-C目标 (<55 mg/dL).
- 尽管LLT的使用增加了,但89.5%的患者的LDL-C水平不受控制.
- 高强度LLT的处方从2.4%上升到16.5%,但中等强度LLT仍然占主导地位.
结论:
- 在ACS后的LLT临床指南的实施方面存在很大的差距.
- 大多数患者在ACS发生一年后未能达到LDL-C目标,这表明治疗效果不佳.
- 需要进一步努力,以优化LLT策略和改善心血管结果.
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