Risk stratification and low-density lipoprotein cholesterol goal attainment rates in patients with very high-risk or extreme high-risk atherosclerotic cardiovascular diseases regarding three guidelines
10.3760/cma.j.cn112138-20210529-00379
- VernacularTitle:比较3种不同指南/共识评价极高风险或超高危动脉粥样硬化性心血管疾病危险分层和血脂达标率差异
- Author:
Nan NAN
1
;
Huijuan ZUO
;
Yuan ZHOU
;
Min ZHANG
;
Mingduo ZHANG
;
Dongfeng ZHANG
;
Jinfan TIAN
;
Bingyu GAO
;
Xiaolu NIE
;
Lirong LIANG
;
Jie LIN
;
Xiantao SONG
Author Information
1. 首都医科大学附属北京安贞医院心内冠心病中心一区，北京100029
- Keywords:
Atherosclerosis;
Cardiovascular diseases;
Risk assessment;
Low-density lipoprotein cholesterol;
Goal attainment rates
- From:
Chinese Journal of Internal Medicine
2022;61(4):377-383
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the differences of risk stratification of very high-risk or extreme high-risk atherosclerotic cardiovascular diseases (ASCVD) and the attainment rates of low-density lipoprotein cholesterol (LDL-C) management targets evaluated by three different criteria, and the causal attributions of these differences.Methods:Patients with ASCVD were consecutively enrolled from January 1 to December 31 in 2019, and were evaluated for very high-risk or extreme high-risk and LDL-C goal attainment rates with 2018 American guideline on the management of blood cholesterol (2018AG), 2019 China Cholesterol Education Program (CCEP) Expert Advice for the management of dyslipidemias (2019EA) and 2020 Chinese expert consensus on lipid management of very high-risk ASCVD patients(2020EC), respectively. The causal attributions of the differences in attainment rates were analyzed as well.Results:A total of 1 864 ASCVD patients were included in this study. According to 2018AG, 2019EA and 2020EC, the proportions of the patients with very high-risk or extreme high-risk were 59.4%, 90.7%, and 65.6%, respectively. The absolute LDL-C target attainment rates were 37.2%, 15.7%, and 13.7%, respectively, the differences between each two rates were statistically significant (all P<0.001). As to the differences in attainment rates between 2020EC and 2018AG, 61.5% were due to the different LDL-C goal attainment values and 38.5% were caused by the different risk stratifications, while for the differences between 2020EC and 2019EA attainment rates, different LDL-C goal attainment values were responsible for 13.2%, and different risk stratifications were responsible for 86.8% of the differences. Conclusions:There are significant differences in the proportions and LDL-C attainment rates among the three different criteria for very high-risk or extreme high-risk ASCVD. 2020EC showed a moderate proportion of patients with extreme high-risk, and had the lowest LDL-C attainment rate. The differences between 2020EC and 2018AG are mainly due to the LDL-C target values, and the differences between 2020EC and 2019EA are mainly caused by the risk stratifications.
