Influencing Factors Of LDL-Cholesterol Goal Attainment In Patients After PCI

Background and object Epidemiological surveys have shown that the prevalence and mortality of cardiovascular diseases continue to increase in China.The number of patients with cardiovascular disease is estimated to be about 290 million,of which the population of patients with coronary heart disease is about 11 million in China.The mortality rate of cardiovascular disease is higher than that of tumors and other diseases,which is more than 40% of the death rate of residents.The total cost of hospitalization for heart disease has also increased.The cost of medical treatment due to cardiovascular disease is growing much faster than the growth rate of the gross national product,the burden of the national life is increasing,which has become an important public health problem.The prevention and the treatment of cardiovascular diseases are ought to be given enough attention and urgently needed to be resolved.Coronary heart disease is a common disease of cardiovascular disease.The prevalence of coronary heart disease over 60 years old is 27.8‰ in Chinese population.The total number of interventional treatments for coronary heart disease was 567 583 cases/year in the mainland;on average,426.82 patients per 100,000 patients underwent percutaneous coronary intervention;the average number of implants was about 1.5 per case.The mortality rate of interventional therapy is stable at a low level.Related experimental results suggest that for every 1 mmol/L reduction in low-density cholesterol ester levels,the risk of major cardiovascular adverse events is reduced by approximately 22%.Multiple coronary heart disease studies have shown that statin therapy in patients with low-density cholesterol esters has a significantly lower allcause mortality and cardiovascular mortality;and blood lipid levels are significantly associated with postoperative coronary intervention.In recent years,the guidelines recommend that the target value of blood lipid control be determined based on the stratified risk assessment of atherosclerotic cardiovascular disease.Patients with previous diagnosis of coronary heart disease who underwent coronary intervention were patients in the very high risk group.The guidelines require that the level of lipid low cholesterol cholesterol in this population should be controlled below 1.8mmoL/L.In China,there are few follow-up data on blood lipid control,especially coronary artery and postoperative patients,and the available data show that the blood lipid control compliance rate varies greatly in different regions;there is no relevant data in Jingzhou.The purpose of this study was to evaluate the blood lipid compliance rate of patients after coronary stent implantation in this area,and to analyze the influencing factors of blood lipid compliance rate,so as to provide a basis for better secondary prevention and management of postoperative coronary heart disease.Methods A total of 133 patients underwent coronary artery stenting in the First People's Hospital of Jingzhou from December 2016 to November 2017.Review previous cases to understand the patient's basic information and medical history.After follow-up in February 2018,the Drug Compliance Scale and the Seattle Angina Scale were completed and the blood lipids were reviewed.According to the blood lipid target value of patients after coronary stent implantation recommended in the 2016 Guidelines for Prevention and Treatment of Adults with Experimental Lipids,the patient's blood lipid low density lipoprotein cholesterol(LDL-C)control rate was calculated.Logistic regression analysis was performed on the factors influencing the blood lipids.Results Logistic regression analysis showed that sustained statins-taken history(OR =0.43,P =0.005)and high treatment adherence(OR =0.42,P =0.045)were the protective factors of LDL-C goal attainment,while overweight(OR =1.31,P =0.040),more types of medication(OR =3.70,P =0.001)were risk factors.Postoperative follow-up showed that the reduction of angina occurrence(67.67±12.13vs56.49±13.97)and angina recurring(11.61±1.02 v s 10.14±1.54)in patients of achievement group was significantly higher than those of patients in non-achievement group evaluated by Seattle angina questionnaire(P < 0.05,respectively).Conclusion The study result suggests that sustained statins-taken history and high treatment adherence are the protective factors of LDL-C goal attainment,while overweight and more types of medication are risk factors.