Prehospital statin use and low-density lipoprotein cholesterol levels at admission in acute coronary syndrome patients with history of myocardial infarction or revascularization: Findings from the Improving Care for Cardiovascular Disease in China (CCC) project

Autor: Louise Morgan, Changsheng Ma, Mengge Zhou, Ccc-Acs Investigators, Kathryn A. Taubert, Yongchen Hao, Jun Liu, Jing Liu, Yong Huo, Junbo Ge, Gregg C. Fonarow, Dong Zhao, Yaling Han, Na Yang, Sidney C. Smith, Yueyan Xing
Rok vydání: 2018
Předmět:
Cardiovascular disease in China
Male
medicine.medical_specialty
Acute coronary syndrome
China
Emergency Medical Services
Statin
medicine.drug_class
medicine.medical_treatment
030204 cardiovascular system & hematology
Revascularization
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Internal medicine
medicine
Humans
030212 general & internal medicine
Myocardial infarction
Registries
Acute Coronary Syndrome
Aged
Retrospective Studies
business.industry
Cholesterol
Retrospective cohort study
Cholesterol
LDL
Statin treatment
medicine.disease
Quality Improvement
Hospitalization
chemistry
Cardiovascular Diseases
lipids (amino acids
peptides
and proteins)
Female
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Morbidity
Cardiology and Cardiovascular Medicine
business
Biomarkers
Zdroj: American heart journal. 212
ISSN: 1097-6744
Popis: Lowering low-density lipoprotein cholesterol (LDL-C) by statins is a key strategy for secondary prevention of acute coronary syndrome (ACS). However, few studies have examined prehospital statin use and admission LDL-C levels in ACS patients with history of myocardial infarction (MI) or revascularization. This study aimed to assess use of prehospital statins and LDL-C levels at admission in ACS patients with history of MI or revascularization.Improving Care for Cardiovascular Disease in China project was a nationwide registry, with 192 participating hospitals reporting details of clinical information of ACS patients from November 2014. By May 2018, 80,282 patients with ACS were included. LDL-C levels were obtained from the initial admission lipid testing.Of the 80,282 ACS patients, 6,523 with a history of MI or revascularization were enrolled. Among them, 50.8% were receiving lipid-lowering therapy before hospitalization (statin monotherapy in 98.4%, combination in 1.2%). A total of 30.1% of patients had LDL-C 70 mg/dL at admission. In patients receiving prehospital statins, 36.1% had LDL-C 70 mg/dL compared to 24.0% without prehospital statins (P .001). At discharge, 91.8% of patients were treated with statin monotherapy, 90.7% at moderate doses irrespective of prehospital statin use and LDL-C levels at admission.Among ACS patients with history of MI or revascularization, half were not being treated with statin therapy prior to admission, and most had not attained LDL-C 70 mg/dL despite prehospital statin use. There is an important opportunity to provide intensive statin or combination lipid-lowering therapy to these very high risk patients.
Databáze: OpenAIRE
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