冠脉支架植入术≥75岁患者的临床特征和随访现状及低密度脂蛋白胆固醇达标率  

Clinical characteristics and follow-up status of patients aged 75 years and above undergoing coronary stenting and the rate of achieving low-density lipoprotein cholesterol

作　　者：陈晨[1] 杨燕洲 雷新军[1] 孙晨捷 肖懿慧 CHEN Chen;YANG Yanzhou;LEI Xinjun;SUN Chenjie;XIAO Yihui(Department of Cardiology,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061;Department of Cardiology,Baoji People’s Hospital,Baoji 721000;Department of Cardiology,Dingbian County People’s Hospital,Yulin 718600,China)

机构地区：[1]西安交通大学第一附属医院心血管内科,陕西西安710061 [2]宝鸡市第二人民医院心血管内科,陕西宝鸡721000 [3]定边县人民医院心血管内科,陕西榆林718600

出　　处：《西安交通大学学报（医学版）》2023年第6期904-909,共6页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：国家自然科学基金青年项目(No.82000414);陕西省重点研发计划资助项目(No.2019F-178);西安交通大学第一附属医院一般项目(No.2018MS-14)。

摘　　要：目的了解住院期间行冠脉支架植入术的动脉粥样硬化性心血管疾病(ASCVD)中≥75岁患者的临床特征和长期随访率及低密度脂蛋白胆固醇(LDL-C)水平和达标率。方法选取2016年1月至2020年12月于西安交通大学第一附属医院住院且于住院期间行经皮冠脉支架植入术的年龄≥75岁的ASCVD患者,通过HIS系统收集患者的住院基线资料和出院后1个月、3个月、6个月、12个月的随访情况,分析其每次随访检测的LDL-C水平及达标率。结果共入选1129例患者,年龄为78(75,89)岁,72.1%为男性,心肌梗死为ASCVD的主要类型(71.5%),高血压为最常见的风险因素,占85.2%(717/842),糖尿病次之,占58.6%(493/842),其中74.6%符合2020年《超高危ASCVD患者血脂管理中国专家共识》的超高危标准,其LDL-C达标率仅为8.1%;1129例高龄ASCVD患者常规4次随访率分别为49.5%、24.1%、17.1%、24.6%,完成常规随访并行LDL-C的检测率分别为26.3%、5.3%、10.4%、13.8%,其中超高危ASCVD患者随访期间的LDL-C达标率分别为59.4%、45.1%、37.1%、17.6%,非超高危ASCVD患者LDL-C达标率分别为67.3%、55.6%、47.4%、44.0%。结论住院期间行冠脉支架植入术的高龄ASCVD患者以超高危ASCVD为主,其常规随访率及随访期间LDL-C达标率低且呈下降趋势。Objective To investigate the clinical characteristics,long-term follow-up rate,level and control rate of low-density lipoprotein cholesterol(LDL-C)in patients with atherosclerotic cardiovascular disease(ASCVD)aged≥75 years who underwent percutaneous coronary intervention(PCI)during hospitalization.Methods We selected ASCVD patients aged≥75 years with PCI from January 2016 to December 2020 in The First Affiliated Hospital of Xi’an Jiaotong University,collected the baseline data of the patients and the follow-up of 1 month,3 months,6 months and 12 months after discharge by HIS system,and analyzed their LDL-C and control rate at each follow-up.Results A total of 1129 patients were enrolled in this study,aged 78(ranging from 75 to 89)years.Among them 72.1%were male;myocardial infarction was the main type of ASCVD(71.5%);hypertension was the most common risk factor,accounting for 85.2%(717/842),followed by diabetes,58.6%(493/842);74.6%met the ultra-high risk criteria of the 2020 Chinese Expert Consensus on Lipid Management in Ultra-High Risk ASCVD Patients,and the LDL-C control rate was only 8.1%.The four routine follow-up rates of 1129 elderly ASCVD patients were 49.5%,24.1%,17.1%,and 24.6%,respectively.The detection rates of LDL-C during follow-up were 26.3%,5.3%,10.4%,and 13.8%,respectively.LDL-C control rates in ultra-high risk ASCVD were 59.4%,45.1%,37.1%,and 17.6%,respectively,while LDL-C control rates in non-ultra-high risk ASCVD patients were 67.3%,55.6%,47.4%,and 44.0%,respectively.Conclusion The elderly patients with ASCVD-PCI were mainly ultra-high risk patients.The routine follow-up rate and the LDL-C compliance rate during follow-up were low and showed a downward trend.

关 键 词：≥75岁 冠脉支架植入术 随访现状 低密度脂蛋白胆固醇(LDL-C) 达标率 

分 类 号：R541.4[医药卫生—心血管疾病]