Trends in lipid management among patients with coronary artery disease
Trends in lipid management among patients with coronary artery disease
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DOI：
10.2337/diacare.26.4.991
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发表时间：
2003-04-01
期刊：
影响因子：
16.2
通讯作者：
Simpson, RJ
中科院分区：
文献类型：
--
作者：
Massing, MW;Foley, KA;Simpson, RJ
目的-检查冠心病（CAD）合并和不合并糖尿病患者的血脂管理趋势，以确定糖尿病患者是否开始接受与其高风险相一致的积极的血脂管理。1996年至1998年期间，在295个医疗实践中参与质量保证计划II的813名CAD患者。血脂检测率，血脂治疗率，和血脂浓度的冠心病患者，并没有糖尿病层内的办公室visitedate.Results-Lipid检测和治疗率增加，平均血脂水平显着下降，随着时间的推移。与非糖尿病患者相比，糖尿病患者的血脂水平降低了26%，接受降脂药物治疗的可能性降低了17%，而且这种差异并没有随着时间的推移而缩小。在接受治疗的患者中，平均非高密度脂蛋白胆固醇（非HDL-C）和低密度脂蛋白胆固醇（LDL-C）下降不太迅速，随着时间的推移，患者机智没有diabetes. Conclusions，虽然令人印象深刻的进展，在门诊血脂管理的CAD患者，血脂管理的CAD患者糖尿病改善没有更快，在某些情况下，不太快，比非糖尿病患者。考虑到他们的高风险，需要更多的努力来确保CAD合并糖尿病患者接受积极的脂质管理。
Objective- To examine lipid management trends for coronary artery disease (CAD) patients with and without diabetes in order to determine whether those with diabetes are beginning to receive aggressive lipid management consistent with their elevated risk.Research Design and Methods-We used outpatient medical record data from 47,813 CAD patients seen at 295 medical practices participating in the Quality Assurance Program II between 1996 and 1998. Lipid testing rates, lipid treatment rates, and serum lipid concentrations are described for CAD patients with and without diabetes within strata of office visit date.Results-Lipid testing and treatment rates increased and mean lipid levels decreased markedly over time. Those with diabetes were 26% less likely to have a lipid profile and 17% less likely to receive a lipid-lowering medication than their nondiabetic counterparts, and this disparity did not diminish over time. Among treated patients, mean non-HDL cholesterol (non-HDL-C) and LDL cholesterol (LDL-C) declined less rapidly over time for patients wit without diabetes.Conclusions-Although impressive progress was made in the outpatient lipid management of CAD patients, lipid management for CAD patients with diabetes improved no more rapidly, and in some cases less rapidly, than for nondiabetic patients. Given their higher risk, more effort is needed to ensure that CAD patients with diabetes receive aggressive lipid management.