中青年超高危ACS患者低密度脂蛋白胆固醇水平及降胆固醇药物使用现状  

Low-density lipoprotein cholesterol levels and lipid-lowering treatment status among young and middle-aged ultra-high-risk patients with acute coronary syndrome in China

作　　者：刘军 赵冬 郝永臣 杨娜 孙兆庆 刘静 Liu Jun;Zhao Dong;Hao Yongchen;Yang Na;Sun Zhaoqing;Liu Jing;on behalf of all investigators in the Improving Care for Cardiovascular Disease in China Project(Center of Clinical&Epidemiology,Beijing Anshan Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院,北京市心肺血管疾病研究所临床与流行病研究中心,北京100029

出　　处：《中华心血管病杂志》2022年第12期1161-1168,共8页Chinese Journal of Cardiology

摘　　要：目的了解中国中青年超高危急性冠状动脉综合征(ACS)患者低密度脂蛋白胆固醇(LDL-C)水平及降胆固醇药物使用现状。方法本研究基于中华医学会心血管病学分会(CSC)和美国心脏协会(AHA)合作的中国心血管疾病医疗质量改善(CCC)项目。该项目在全国159家三级医院和82家二级医院连续入选ACS住院患者,系统收集患者临床相关信息。本研究纳入CCC项目2014年11月至2019年12月入选的中青年(年龄18~59岁)ACS住院患者,根据CSC《超高危动脉粥样硬化性心血管疾病患者血脂管理中国专家共识》超高危患者的界定标准,分析超高危ACS患者LDL-C平均水平及院前接受调脂治疗情况。结果研究共纳入42230例中青年ACS住院患者,年龄(50.4±6.9)岁,男性86.8%(36676/42230)。86.9%(36687/42230)的患者符合超高危标准。超高危ACS患者入院时LDL-C水平为(2.8±1.0)mmol/L,仅有5.3%(1948/36687)的患者达到1.4 mmol/L的目标值。超高危患者中,17.5%(6430/36687)的患者院前服用调脂药物,其中96.4%(6198/6430)的患者采用他汀单药治疗。接受他汀治疗的超高危患者中,9.9%(626/6323)的患者LDL-C<1.4 mmol/L。结论中青年ACS住院患者中绝大多数属于超高危,需要采用更低的LDL-C降脂治疗目标。超高危患者院前较少服用降胆固醇药物,大部分患者入院时LDL-C水平高于推荐的目标值且距目标值的差距较大。Objective To assess low-density lipoprotein cholesterol(LDL-C)levels and use of lipid-lowering treatment among young and middle-aged ultra-high-risk patients with acute coronary syndrome(ACS)in China.Methods The study was based on the“Improving Care for Cardiovascular Disease in China(CCC)-ACS”project,a collaborative registry by and Chinese Society of Cardiology(CSC)and the American Heart Association.Hospitalized-patients with ACS were consecutively enrolled from 159 tertiary and 82 secondary hospitals across China,related clinical information was collected.This study included young and middle-aged hospitalized patients(18-59 years)with ACS from November 2014 to December 2019 registered in CCC-ACS project.Ultra-high-risk was defined according to Chinese expert consensus on lipid management of ultra-high-risk atherosclerotic cardiovascular disease(ASCVD)patients of CSC.The mean LDL-C levels at admission,pre-hospital lipid-lowering therapy and proportion of patients with LDL-C target achieved were analyzed.Results A total of 42230 patients younger than 60 years with ACS were included in this study.The mean age was(50.4±6.9)years,and 86.8%(36676/42230)of the ACS patients were male.Among them,86.9%(36687/42230)met the criteria of ultra-high-risk.The mean level of LDL-C at admission was(2.8±1.0)mmol/L,only 5.3%(1948/36687)patients achieved the targeted goal of LDL-C<1.4 mmol/L.Among the ultra-high-risk ASCVD patients,17.5%(6430/36687)received lipid-lowering drugs before hospitalization,96.4%(6198/6430)of whom received statins monotherapy.Among patients receiving pre-hospital statins,only 9.9%(626/6323)patients reached an LDL-C<1.4 mmol/L at admission.Conclusions The majority of young and middle-aged hospitalized patients with ACS are ultra-high-risk patients for ASCVD in China.Pre-hospital lipid-lowering drugs use is lower in these ultra-high-risk ASCVD patients and most patients do not reach the new LDL-C target level at admission.

关 键 词：急性冠状动脉综合征 中青年 超高危 LDL-C达标 

分 类 号：R541.4[医药卫生—心血管疾病]