Investigation Of Statin Use And LDL-C Compliance Rate In Patients With AMI In A Tertiary Hospital In Xinjiang

Objective:To investigate the use of statins in patients with acute myocardial infarction in a tertiary hospital in Xinjiang,and the compliance rate of low-density lipoprotein cholesterol after discharge.Methods : Patients with acute myocardial infarction who were hospitalized in the Department of Cardiology of the First Affiliated Hospital of Shihezi University School of Medicine from May 2017 to September 2018 were selected as the research objects,and the types and doses of statins used by patients after admission were investigated.Guidelines for the prevention and treatment of dyslipidemia,to evaluate the compliance rate of LDL cholesterol at 3 and 12 months after discharge.Results:A total of 487 patients with acute myocardial infarction were collected basic clinical data.After 1 year of follow-up,257 patients were successfully followed up.1.Basic information: The average age of the patients was 58.3 ± 11.7 years,of which 181 patients(70.4%)were aged 65 years or younger,and 76 patients(29.6%)were aged 65 years or older.The age of male patients was 56.2 ± 11.0 years,and the age of female patients was 66.8 ± 10.6 years.There were 207 males(80.5%)and 50 females(19.5%).There were 236 Han people(91.8%)and 21 minority people(8.2%).There were 155 smoking patients(60.3%),72 drinking patients(28.0%),200 patients with acute ST-segment myocardial infarction(77.8%),and 57 patients with acute non-ST-segment myocardial infarction(22.2%).39 patients with previous history of coronary heart disease(15.2%),31 patients with family history of coronary heart disease(12.1%),125 patients with hypertension(48.6%),male patients with hypertension accounted for 42.0%,and female patients with hypertension accounted for 76.0%,the proportion of women with hypertension was higher than that of men(P <0.01).There were 91 patients with diabetes mellitus(35.4%),34.8% of men with diabetes and 38% of women.There was no difference between the two(P> 0.05).There were 93 patients with hyperlipidemia(36.2%),35.3% of male patients with hyperlipidemia and 40.0% of female patients.There was no difference between the two(P> 0.05).There were 56 patients with heart failure(21.8%).BMI of 257 patients with AMI was 25.87 ± 2.86 kg / m2,total serum cholesterol was 4.18 ± 0.95 mmol / L,triglyceride was 1.60 ± 1.04 mmol / L,low-density lipoprotein cholesterol was 2.49 ± 0.73 mmol / L,and high density The lipoprotein cholesterol was 1.03 ± 0.21 mmol / L.2.Use of secondary preventive drugs after admission: 252 cases(98.1%)of antiplatelet drugs,257 cases(100.0%)of statins,179 cases(69.65)of beta blockers,and 141 cases(54.9%)of ACEI / ARB.Among them,atorvastatin patients accounted for 30.7%(79/257),rosuvastatin patients accounted for 62.3%(160/257),and pitavastatin patients accounted for 7.0%(18/257).There were 79 cases of atorvastatin 20 mg,6 cases of rosuvastatin 5mg,154 cases of rosuvastatin 10 mg,and 18 cases of pitavastatin 2mg.All patients were treated with moderate-intensity statins,without other types Lipid lowering medicine.3.The baseline level of low-density lipoprotein at the time of admission for acute myocardial infarction: Among 257 AMI patients,the LDL-C level was 2.49 ± 0.73 mmol / L,of which 17.9% were patients with LDL-C <1.80 mmol / L 257),1.80 mmol / L?LDL-C <2.60 mmol / L accounted for 40.5%(104/257),2.60 mmol / L?LDL-C <3.40 mmol / L accounted for 30.7%(79/257)Patients with LDL-C ? 3.40 mmol / L accounted for 10.9%(28/257).Baseline levels of LDL-C in female patients were higher than those in men(P <0.05).Baseline levels of LDL-C were higher in patients aged 65 years or younger than those aged 65 years(P <0.05).Patients with a previous history of coronary heart disease had LDL-C baseline levels were lower than those without a history of coronary heart disease(P <0.05).4.Out-of-hospital LDL cholesterol compliance and influencing factors: 257 patients with acute myocardial infarction achieved LDL-C compliance rates of 62.6%(161/257)and 43.6%(112 / 257),the percentage of LDL-C meeting the standards for 3 months and 12 months was 36.7%(95/257).Among them,women,age ? 65 years,patients with hyperlipidemia,and high baseline levels of LDL-C had lower LDL-C compliance rates within 3 months after discharge(P <0.05);patients with hyperlipidemia,LDL-C Patients with high baseline levels had lower LDL-C compliance rates at 12 months after discharge(P <0.05);patients taking different types of statins had no difference in LDL-C compliance rates at 3 months and 12 months after discharge(P> 0.05).Multivariate Logistic regression analysis showed that females,younger age,and higher baseline LDL-C levels at admission were independent risk factors for the compliance rate of AMI patients 3 months after discharge.5.Adverse reactions of statins: Of the 257 patients with acute myocardial infarction using statins,6 had liver toxicity,1 had gastrointestinal reactions,and no other adverse reactions such as myalgia appeared.Conclusion: 1.AMI patients have low LDL-C compliance rate after discharge,females,middle-aged and young,combined with hyperlipidemia,and high LDL-C baseline levels are influencing factors for LDL-C compliance rate after discharge from AMI patients.Add emphasis on fat treatment.2.The statin usage rate of AMI patients after admission is high,and it is mainly based on medium-dose strong statins,which basically meets the recommendations of domestic and foreign guidelines.Atorvastatin,rosuvastatin,pitavastatin can effectively reduce LDL-C levels in patients with AMI,the incidence of adverse reactions is low,and it is safe and effective in clinical application.