Low-density lipoprotein cholesterol target goal attainment rate and related factors in patients with acute coronary syndrome after percutaneous coronary intervention / 中华心血管病杂志

ABSTRACT

<p><b>OBJECTIVE</b>To observe the low-density lipoprotein cholesterol (LDL-C) target goal attainment rate and related factors in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI).</p><p><b>METHODS</b>From March 2011 to March 2012, a total of 832 ACS patients were retrospectively evaluated in the Cardiology Department of the First Affiliated Hospital of Dalian Medical University. The target goal attainment rate after PCI was defined as the percentage of patients reaching LDL-C goals recommended by The European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS) guidelines for the management of dyslipidemias (European guidelines) and Chinese guidelines on prevention and treatment of dyslipidemias in adults and Chinese guidelines on percutaneous coronary artery intervention treatment (Chinese guidelines). Multivariate logistic regression analysis was used to analyze the related factors.</p><p><b>RESULTS</b>According to the European guidelines, the overall LDL-C goal attainment rates at 1 month and 9 months after PCI were 25.2% (210/832) and 22.2% (186/832), respectively. According to the Chinese guidelines, the overall LDL-C goal attainment rates at 1 month and 9 months after PCI were 46.5% (387/832) and 42.3% (352/832), respectively. In accordance with the Chinese guidelines, the multivariate logistic regression analysis showed that gender (females/males, OR = 0.650, 95%CI 0.442-0.956), age ( ≥ 60 years/<60 years, OR = 0.628, 95%CI0.464-0.850), hypertension (OR = 0.737, 95%CI 0.547-0.994), prior myocardial infarction history (OR = 0.696, 95%CI0.511-0.948), prior PCI history (OR = 0.575, 95%CI 0.339-0.974) and baseline LDL-C levels ( OR = 0.155, 95%CI 0.096-0.252) were independent risk factors that affected LDL-C goal attainment at 1 month post PCI. Moreover, the following parameters were the independent risk factors for LDL-C goal attainment at 9 months after PCI prior myocardial infarction history (OR = 0.706, 95%CI0.521-0.958), prior PCI history (OR = 0.565, 95%CI0.334-0.957) and baseline LDL-C levels (OR = 0.176, 95%CI0.110-0.282).</p><p><b>CONCLUSIONS</b>Currently, the LDL-C control rate is low in patients with ACS after PCI. The cholesterol lowering therapy should be individually strengthened for patients after PCI, especially in female patients, patients with aged ≥ 60 years old, hypertension, prior myocardial infarction history, prior PCI history and higher baseline LDL-C level.</p>