ABSTRACT
@#Objective To investigate the effect of blood glucose levels on lipid-lowering therapy in patients with myocardial infraction (MI).Methods The data of 174 patients with acute or old MI and finished a two-year follow-up were analyzed retrospectively. The patients were divided into four groups: diabetes mellitus (DM) with well blood glucose control (DM+W group), diabetes mellitus with bad blood glucose control (DM+B group), non-diabetes mellitus with well blood glucose control (NDM+W group) and non-diabetes mellitus with bad blood glucose control (NDM+B group). Blood lipids levels, dose and side effects of statins were statistically analyzed.Results All the 174 patients had a mean follow-up period of 28±7 months, and 51 patients (25.9%) had diabetes mellitus. In DM+B group (n=13, 25.5%) and NDM+B group (n=24, 19.5%), there were no statistically difference between enrollment and 2-year follow-up in the mean levels of blood total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-c) and low density lipoprotein cholesterol (LDL-c), but the mean level of LDL-c had a trend of elevation. In DM+W group, the mean level of LDL-c was 2.57 mmol/L at 2-year follow-up, which did not achieve the recommended LDL-c goal (2.06 mmol/L). There were no differences in statin therapy between each group. After 2-year follow-up, there were only 93 patients (53.4%) received normal dose of statin, 60 patients (34.5%) took low dose of statin and 16 patients (9.2%) had no statin therapy. There were no differences in hepatic enzyme abnormality between each group.Conclusion The bad control of blood glucose in patients with MI effect the efficacy of statins in lipid-lowering therapy. The doses of statin are insufficient especial in patients with MI and DM.
ABSTRACT
Prevention is necessary to decrease the incidence rate,morbidity and mortality of acute cerebral infarction.Primary prevention is the etiological method to stop the occurrence.The method is to deal with the risk factors effectively in the at-risk population,which includes modifying hypertension,cardiac disease,diabetes mellitus,dyslipidemia,hypercoagulable state,carotid stenosis,hyperhomocysteinemia,and metabolism syndrome,quitting smoking,less wine,reasonable diet,moderate weight reduction,strengthening sports,maintaining psychological balance,avoiding predisposing factors.Second prevention is to assess the etiology and pathogenesis,treat reversible etiology and control interventional risk factors of the first onset in order to prevent recurrent cerebral infarction.