Low-density lipoprotein cholesterol levels and lipid-lowering treatment status among young and middle-aged ultra-high-risk patients with acute coronary syndrome in China.
10.3760/cma.j.cn112148-20220920-00731
- Author:
Jun LIU
;
Dong ZHAO
;
Yong Chen HAO
;
Na YANG
;
Zhao Qing SUN
;
Jing LIU
- Publication Type:Journal Article
- MeSH:
Middle Aged;
United States;
Humans;
Male;
Adult;
Female;
Cholesterol, LDL;
Acute Coronary Syndrome/drug therapy*;
Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use*;
China;
Atherosclerosis/drug therapy*;
Hypolipidemic Agents/therapeutic use*
- From:
Chinese Journal of Cardiology
2022;50(12):1161-1168
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To assess low-density lipoprotein cholesterol (LDL-C) levels and use of lipid-lowering treatment among young and middle-aged ultra-high-risk patients with acute coronary syndrome (ACS) in China. Methods: The study was based on the"Improving Care for Cardiovascular Disease in China (CCC)-ACS"project, a collaborative registry by and Chinese Society of Cardiology (CSC) and the American Heart Association. Hospitalized-patients with ACS were consecutively enrolled from 159 tertiary and 82 secondary hospitals across China, related clinical information was collected. This study included young and middle-aged hospitalized patients (18-59 years) with ACS from November 2014 to December 2019 registered in CCC-ACS project. Ultra-high-risk was defined according to Chinese expert consensus on lipid management of ultra-high-risk atherosclerotic cardiovascular disease (ASCVD) patients of CSC. The mean LDL-C levels at admission, pre-hospital lipid-lowering therapy and proportion of patients with LDL-C target achieved were analyzed. Results: A total of 42 230 patients younger than 60 years with ACS were included in this study. The mean age was (50.4±6.9) years, and 86.8% (36 676/42 230) of the ACS patients were male. Among them, 86.9% (36 687/42 230) met the criteria of ultra-high-risk. The mean level of LDL-C at admission was (2.8±1.0)mmol/L, only 5.3 % (1 948/36 687) patients achieved the targeted goal of LDL-C<1.4 mmol/L. Among the ultra-high-risk ASCVD patients, 17.5% (6 430/36 687) received lipid-lowering drugs before hospitalization, 96.4% (6 198/6 430) of whom received statins monotherapy. Among patients receiving pre-hospital statins, only 9.9% (626/6 323) patients reached an LDL-C<1.4 mmol/L at admission. Conclusions: The majority of young and middle-aged hospitalized patients with ACS are ultra-high-risk patients for ASCVD in China. Pre-hospital lipid-lowering drugs use is lower in these ultra-high-risk ASCVD patients and most patients do not reach the new LDL-C target level at admission.
