急性冠状动脉事件入院前心血管危险因素管理不足。

Christos Siafarikas, Stavros Liatis, Christos Kapelios, Marina Skouloudi, Maria Bonou, John Barbetseas
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引用次数: 0

摘要

目的:对可改变的危险因素的最佳调节已被提出作为心血管疾病(CVD)一级和二级预防的护理标准。本研究的目的是评估急性冠状动脉事件入院前接受的原发性和继发性心血管风险管理。方法:对某大学附属医院心内科每年(2019年1月7日至2020年6月30日)确诊为急性冠脉综合征(ACS)的185例连续住院患者的资料进行分析。根据既往心血管疾病(CVD)病史,将研究人群分为一级预防和二级预防两组。结果:参与者平均年龄为65.5±12.2岁,男性居多(81.6%)。既往CVD患者51例(27.9%)。57例(30.8%)患者有糖尿病史,97例(52.4%)患者有血脂异常史。101例(54.6%)患者存在高血压。在二级预防组中,只有33.3%的患者LDL-C达标,而20%的患者没有使用他汀类药物。使用抗血小板/抗凝剂的占94.5%。在糖尿病患者中,只有20%的患者使用GLP-1受体激动剂或/和SGLT-2抑制剂,而HbA1c达到目标的患者占47.8%。25%的患者是活跃的吸烟者。在一级预防组中,他汀类药物的使用总体较低(25.8%),但在糖尿病患者和非糖尿病患者中使用频率更高(分别为47.1%和32.1%)。低于23.1%的患者LDL-C达标。抗血小板/抗凝药物的使用率较低(20.1%),但糖尿病患者的使用率较高(52.9%)。在糖尿病组中,HbA1c达标的比例为61.8%。46.3%的患者有主动吸烟行为。结论:我们的数据显示,在相当大比例的ACS患者中,先前的CVD预防,无论是一级还是二级,都不能满足科学学会目前提供的建议。
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Inadequate management of cardiovascular risk factors prior to admission for an acute coronary event.

Objectives: Optimal regulation of modifiable risk factors has been proposed as the standard of care both for primary and secondary prevention of cardiovascular disease (CVD). The aim of this study was to assess primary and secondary cardiovascular risk management received before admission for an acute coronary event.

Methods: Data were analyzed for 185 consecutive hospitalized patients with a diagnosis of acute coronary syndrome (ACS) in the Cardiology department of a University hospital during an annual period (1/7/2019 until 30/6/2020). The study population was divided into two groups, the primary and secondary prevention subgroups, according to previous medical history of cardiovascular disease (CVD).

Results: The mean age of the participants was 65.5 ±12.2 years and most patients were male (81.6%). Previous CVD was present in 51 patients (27.9%). Fifty-seven patients (30.8%) had a history of diabetes mellitus (DM) and 97 (52.4%) had a history of dyslipidemia. Hypertension was present in 101 (54.6%) patients. In the secondary prevention group, the LDL-C was on target in only 33.3% of the patients, while 20% patients did not use statins. The use of antiplatelet/anticoagulant agents was 94.5%. Among patients with diabetes, only 20% had been using a GLP-1 receptor agonist or/and an SGLT-2 inhibitor, while the HbA1c was on target in 47.8%. Twenty-five percent of the patients were active smokers. In the primary prevention group, the use of statins was overall low (25.8%) but more frequent in patients with diabetes and those without diabetes at very high-risk for CVD (47.1% and 32.1% respectively). The LDL-C was on target in less than 23.1% of the patients. The use of antiplatelet/anticoagulant agents was low (20.1%), but higher in those with diabetes (52.9%). In the diabetic group, HbA1c was on target in 61.8%. Active smoking was practiced by 46.3% of the patients.

Conclusions: Our data show that in a substantial proportion of patients presenting with ACS, previous CVD prevention, both primary and secondary, fails to meet the current recommendations provided by scientific societies.

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来源期刊
Journal of Preventive Medicine and Hygiene
Journal of Preventive Medicine and Hygiene Medicine-Public Health, Environmental and Occupational Health
CiteScore
3.30
自引率
0.00%
发文量
50
期刊介绍: The journal is published on a four-monthly basis and covers the field of epidemiology and community health. The journal publishes original papers and proceedings of Symposia and/or Conferences which should be submitted in English. Papers are accepted on their originality and general interest. Ethical considerations will be taken into account.
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