Statin use and low-density lipoprotein cholesterol levels in patients aged 75 years and older with acute coronary syndrome in China
10.3760/cma.j.issn.0253-3758.2019.05.005
- VernacularTitle: 75岁及以上老年急性冠状动脉综合征住院患者他汀使用现状及低密度脂蛋白胆固醇水平
- Author:
Yueyan XING
1
;
Jing LIU
;
Jun LIU
;
Yongchen HAO
;
Na YANG
;
Mengge ZHOU
;
Dong ZHAO
Author Information
1. Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China
- Publication Type:Journal Article
- Keywords:
Acute coronary syndrome;
Lipoproteins, LDL;
Aged;
Statins
- From:
Chinese Journal of Cardiology
2019;47(5):351-359
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the use of statins and low-density lipoprotein cholesterol (LDL-C) levels at admission in hospitalized patients aged 75 years and older with acute coronary syndrome (ACS) in China.
Methods:Data used in this study derived from the Improving Care for Cardiovascular Disease in China (CCC)-ACS project, a nationwide registry with 150 tertiary hospitals reporting details of clinical information of ACS patients. This study enrolled patients 75 years and older with ACS in CCC-ACS project from November 2014 to June 2017. Patients were divided into two groups according to the history of atherosclerotic cardiovascular disease (ASCVD). Pre-hospital statin use, LDL-C levels at admission and prescription of statins at discharge were reported.
Results:A total of 10 899 patients 75 years and older with ACS were enrolled. The median age was 79 years and 58.7% (6 397 cases) were male. Among patients with history of ASCVD, 33.9% (1 028 cases) of them received statins before hospitalization. Among patients without history of ASCVD, 12.7% (996/7 871) received statins before hospitalization. The mean level of LDL-C was (2.4±0.9) mmol/L and LDL-C was <1.8 mmol/L in 24.7% (747 cases) of patients with history of ASCVD. The mean level of LDL-C was (2.6±0.9) mmol/L and LDL-C was <2.6 mmol/L in 51.7% (4 072 cases) of patients without history of ASCVD. At discharge, 91.2% (9 524/10 488) of patients were prescribed with statins in patients without contraindications for statin.
Conclusion:In elderly patients with recurrent ASCVD, there was an inadequate statin use before hospitalization and most patients did not reach the LDL-C target level when they had the recurrent events. In the elderly ACS patients without history of ASCVD, more than half of the patients had an ideal LDL-C level. It seems that ideal LDL-C level for primary prevention of ACS in elderly people needs to be reevaluated with further studies.
