The Correlation Between Secondary Prevention And Cardiovascular Events In Patients With Coronary Heart Disease Undergoing PCI

Background: With the development of economy and the improvement of living standards,the prevalence and mortality of coronary heart disease have increased year by year.Dyslipidemia plays an important role in the development of coronary heart disease.At present,the pathogenesis of coronary heart disease is relatively clear,and a standardized treatment guideline for coronary heart disease has also been established.The current guidelines recommend secondary prevention of coronary heart disease,including non-drug treatment and drug treatment.Non-drug treatment is mainly to improve the lifestyle and reduce risk factors.Drug therapy refers to the use of antiplatelet,beta-blockers,statins,ACEI/ARB drugs.Drug status and control of risk factors are closely related to the recurrence of cardiovascular events in patients with coronary heart disease.Objective: The purpose of this study was to:(1)dynamically observe secondary prevention medications,medication compliance and risk factors after PCI in patients with coronary heart disease,and observe the relationship between these indicators and the risk of cardiovascular events;(2)Evaluate compliance of risk factors(blood pressure,blood lipids,blood glucose,smoking,etc.)in patients with coronary heart disease;analysis of coronary heart disease patients blood pressure,blood lipids,blood glucose and long-term prognosis of blood pressure,blood lipids,blood glucose for such patients in our country for a long time management provides a certain scientific basis.Subjects and methods: ‘This study included 272 patients with coronary heart disease who underwent PCI in the Department of Cardiology at the First Affiliated Hospital of Fujian Medical University.There were 221 males and 51 females.Baseline patients' age,gender,height,weight,waist circumference,blood pressure,BMI,TC,TG,HDL-C,LDL-C,Non-HDL-C,fasting blood glucose,serum Cr,etc.were followed.Patients were followed up to observe the patient's medication status and Control of risk factors and the occurrence of cardiovascular events.Cardiovascular events were defined as 1,all-cause death 2,nonfatal myocardial infarction;3,coronary revascularization;4,recurrence of angina;5,heart failure;6,non-fatal stroke.Results:(1)?After 45 months of follow-up,there were 83 cases of cardiovascular events.including 21 all-cause deaths,9 non-fatal myocardial infarctions,20 coronary revascularizations,31 recurrent anginas,4 strokes,and 2 heart failures;44.57%(33/83)of cardiovascular events occurred in the first year.Compared with no event group,the baseline age,serum Cr,TC,LDL-C,and Non-HDL-C levels in the event group were significantly higher(P<0.05),and there was no significant difference in other indicators(P>0.05).The base line Non-HDL-C compliance rate? the last LDL-C compliance rate,and the final Non-HDL-C compliance rate were also significantly higher in the event group than in the non-event group.(2)?The use rates of baseline aspirin,clopidogrel,statins,beta blockers,and ACEI/ARB drugs in patients with coronary heart disease were 91.5%,97.8%,97.4%,71.3%,and 46.0%,respectively.After 45 months of follow-up,the rate of secondary preventive drug use decreased: 78.1% for aspirin,23.7% for clopidogrel,90.4% for statins,72.8% for beta-blockers,and 41.2% for ACEI/ARB drugs.After one year of follow-up,the patient's medication compliance gradually decreased from 84.3% in January to 51.8%.(3)?12 months after discharge,dual antiplatelet therapy(aspirin plus clopidogrel)was significantly associated with cardiovascular events at 12 months of follow-up(P<0.05).Patients who did not use dual antiplatelet and statin therapy ?The average 0-2 drugs of follow-up 1 year had a higher incidence of cardiovascular events.(4)?After 45 months of follow-up,the compliance rate of blood lipids and blood pressure was lower and 100 patients had quit smoking;compared with baseline,the LDL-C compliance rate(13.2% vs 32.5%)and Non-HDL-C compliance rate(23.9% vs 57.9)%)significantly increased,but no significant changes in compliance rate of blood pressure,blood glucose(46.0% vs 47.1%,80.1% vs 85.6%,respectively);(5)?Cox proportional hazards model found that baseline age,serum Cr,LDL-C were independent predictors of cardiovascular events,and the OR values are 1.026(95% CI: 1.002-1.050,P: 0.031),1.012(95% CI: 1.005-1.019).,P: 0.001),1.392(95% CI: 1.127-1.720,P: 0.002),respectively.Conclusion: 1.Most of the cardiovascular events after PCI occurred within 1 year,considering that it may be related to the presence of dual antiplatelet therapy for 12 months.;2.The baseline age,serum Cr,TC,LDL-C,and Non-HDL-C levels are correlated with the occurrence of cardiovascular events;...