Contemporary diagnosis and management of hypercholesterolemia in elderly acute myocardial infarction patients: a population-based study.
Contemporary diagnosis and management of hypercholesterolemia in elderly acute myocardial infarction patients: a population-based study.
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老年急性心肌梗死患者高胆固醇血症的当代诊断和治疗：一项基于人群的研究。
DOI：
10.1111/j.1076-7460.2007.04886.x
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
Luepker,RussellV
中科院分区：
文献类型：
--
作者：
Berger,AlanK;Duval,SusanJ;Armstrong,Chris;JacobsJr,DavidR;Luepker,RussellV
有关老年急性心肌梗死(AMI)患者高胆固醇血症的诊断和治疗的数据有限。作者描述了急性心肌梗死住院患者降脂药物的住院和出院处方模式，并确定了与这些疗法使用率低相关的因素。作者分析了明尼苏达心脏调查，这是一个基于人群的监测项目，回顾提取了2001-2002年间明尼阿波利斯-圣保罗大都市区21家医院住院的急性心肌梗死患者的医疗记录。他们确定了2773名30岁及以上的急性心肌梗死患者。总胆固醇为175±45 mg/dL，低密度脂蛋白胆固醇为104±38 mg/dL，高密度脂蛋白胆固醇为44±14 mg/dL。在65岁以下、65-74岁和75岁及以上的患者中，出院时分别有74.6%、63.2%和38.5%的患者使用他汀类药物(P<；.0001)。他汀类药物的使用与其他标准急性心肌梗死疗法--阿司匹林、β阻滞剂、血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂和再灌注治疗--的使用高度相关，并且在接受经皮冠状动脉介入治疗的患者中比在接受冠状动脉搭桥手术的患者中更为普遍。老年患者在急性心肌梗死后接受降脂治疗的可能性仍然较小。需要更多的关注，以确保没有禁忌症的老年急性心肌梗死患者得到适当的降脂治疗。
There are limited data regarding the diagnosis and treatment of hypercholesterolemia in elderly patients with acute myocardial infarction (AMI). The authors describe the inhospital and discharge prescription patterns of lipid‐lowering agents in patients hospitalized with an AMI, and identify factors associated with low rates of utilization of these therapies. The authors analyzed the Minnesota Heart Survey, a population‐based surveillance project that retrospectively abstracted the medical records of patients hospitalized with AMI in 2001–2002 from 21 hospitals in the Minneapolis‐St Paul metropolitan area. They identified 2773 patients 30 years and older with an AMI. The mean total cholesterol was 175±45 mg/dL, the mean low‐density lipoprotein cholesterol was 104±38 mg/dL, and the mean high‐density lipoprotein cholesterol was 44±14 mg/dL. Statins were prescribed at discharge to 74.6%, 63.2%, and 38.5% of patients younger than 65, 65–74, and 75 years and older, respectively (P<.0001). The utilization of statins was highly correlated with the administration of other standard AMI therapies—aspirin, β‐blockers, angiotensin‐converting enzyme inhibitors/angiotensin receptor blockers, and reperfusion therapy—and was more prevalent among patients undergoing percutaneous coronary intervention than among those undergoing coronary artery bypass surgery. Elderly patients remain less likely to receive lipid‐lowering therapy following an AMI. Greater attention is required to ensure that elderly AMI patients without contraindications are appropriately treated with lipid‐lowering therapy.