Lipid Management Of Patients With Coronary Heart Disease Treated After Percutaneous Coronary Intervention Treatment(PCI)

Object:By analyzing the clinical data of patients with coronary heart disease accepted the treatment of percutaneous coronary intervention (PCI) in Heart Center of Affiliated Hospital of Chinese People’s Armed Police Logistics College. To understand the current status of serum lipids in patients with coronary artery disease, and analyze their lipid-lowering therapy and cardiac events during follow-up to explore the associated factors, Providing important information for clinical lipid lowering therapy and reducing adverse cardiac events.Method:Collecting the initial cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), high density lipoprotein (non-HDL-C)、TC/HDL-C and other clinical data of patients with coronary heart disease accepted the treatment of percutaneous coronary intervention (PCI) in Heart Center of Affiliated Hospital of Chinese People’s Armed Police Logistics College with,Using the observation of the hospital,outpatient follow-up and case analysis and recording the serum lipids (TC,TG, HDL-C,LDL-C, the nonHDL-C,TC/HDL-C) and the cardiac events (ischemic attacks of angina, nonfatalmyocardial infarction, cardiogenic shock, ischemic stroke, revascularization) to understand the control of blood lipids present situation, and analyze factors that affect blood lipids compliance and cardiac events.Using case-control study, according to the adult dyslipidemia Prevention Guide", divide into the normal group, the edge of elevated group, increased three groups in accordance with each lipid parameter of patients within24hour and analyze comparative impact of three related factors; according to Statin therapy of TC, LDL-C data after4weeks, divide into the compliance group and the sub-standard group and analyze the influencing factors of the TC, LDL-C reaching the standards. According to whether the follow-up results of adverse cardiac events group and event-free group, the patients were divided two groups.analyze the clinical factors of cardiac events.Results: 1The current lipid situation of the patients before PCI and after PCI817cases of coronary heart disease patients,718patients completed follow-up after four weeks,550patients completed the follow-up after12weeks,381patients completed the follow-up after24weeks,350patients completed the follow-up after48weeks. Three indicators of the, were significant differences(P<0.01) TC, TG, LDL-C decline and were statistically significant (P<0.01). HDL-C increase and were significant differences (P<0.01).2The analysis of influencing factors of preoperative lipids (TC, TG, HDL-C and LDL-C)In TC group,the patient’s body mass index (BMI), non-high-density lipoprotein (non-HDL-C), TC/HDL-C, increased successively in the normal group、in the elevated edge of the group、in the increased group, there are statistics significance (P<0.01);the proportion of women in three groups was statistically rising (P<0.01); The proportion of the History of hypertension in the three groups was56.8%,69.4%,86.2%,(P<0.01); the proportion of a history of diabetes in the three groups were30.8%,43.8%,47.7%(P<0.01); In TG group, the patient’s body mass index (BMI), non-high-density lipoprotein (non-HDL-C), increased successively in the lower group, the normal group, in the elevated group,there are statistics significance (P<0.01); TC/HDL-C was lower (P<0.01); The proportion of women and the proportion of smoking history in three groups were statistically rising (P<0.01); In LDL-C group, the patient’s body mass index (BMI), non-high-density lipoprotein(non-HDL-C), increased successively in the normal groups in the elevated edge of the groups in the increased group, there are statistics significance (P<0.01); the proportion of women in three groups was statistically rising (P<0.01); The proportion of the History of hypertension in the three groups was60.1%,75.0%,94.4%,(P<0.01); the proportion of a history of diabetes in the three groups were30.8%,43.8%,47.7%,was statistically significant (P<0.01).3The analysis of the factors for the TC, LDL-C standard after statin treatment for four weeksIn TC compliance group and sub-standard group, the patients’ body mass index (BMI), non-high-density lipoprotein (non-HDL-C), TC/HDL-C, were higher than and these in sub-standard group with statistical significantly (P<0.01); The proportion of male patients was more than the proportion of female patients in the standards group. There was statistically significant (P<0.01); The proportion of the History of hypertension (59.2%) and the proportion of history diabetes(29.4%) in TC compliance group were significantly lower than proportion of History of hypertension (69.9%) and the proportion of history diabetes(43.9%) in sub-standard groups, with statistical significantly (P<0.01); the ARB drugs and β receptor blockers were important factors that affect TC standards,with statistically significant (P<0.01); In LDL-C compliance group and sub-standard group,the proportion of male patients was more than the proportion of female patients in the standards group. There was statistically significant (P<0.01); The proportion of the History of hypertension (59.0%) and the proportion of history diabetes(29.6%) in LDL-C compliance group were significantly lower than proportion of History of hypertension (73.9%) and the proportion of history diabetes(48.2%) in sub-standard groups, with statistical significantly (P<0.01).4The analysis of influencing factors of adverse cardiac eventsIn TC group, the rate of adverse cardiac event (21.21%) in standard group is significantly lower than the rate (51.56%) in sub-standard group,two groups are statistically significant (P<0.01); In LDL-C group, the rate of adverse cardiac event (27.40%) in standards group is significantly lower than the rate (47.25%) in sub-standard group,two groups are statistically significant (P<0.01); In adverse cardiac events group and no adverse cardiac events group,the patients’ non-high-density lipoprotein (non-HDL-C), TC/HDL-C, hypertension, TC after statin treatment for4weeks are statistically significant (P<0.01); the ARB drugs in two groups are statistically significant (P<0.05). The number of coronary lesions in both groups is statistically significant (P<0.01). Logistic regression analysis, TC after statin drug therapy for four weeks of, TC/HDL-C, the number of coronary lesions and hypertension are factors for adverse cardiac events, and were statistical significance (P<0.05).Conclusion1The lipid levels of718patients after PCI are good. 2The patients’ Age, body mass index (BMI), high density lipoprotein (non-HDL-C), the TC/HDL-C, sex, hypertension, diabetes and smoking, have correlation with the preoperative lipid and postoperative lipid.3The rate of adverse cardiac events in TC and LDL-C standard group is lower than that in sub-standard group; In adverse cardiac events group and no adverse cardiac events group,the patients’non-high-density lipoprotein (non-HDL-C), TC/HDL-C, hypertension, TC after statin treatment for4weeks are statistically significant (P<0.01); the ARB drugs in two groups are statistically significant (P <0.05). The number of coronary lesions in both groups is statistically significant (P <0.01). Logistic regression analysis, TC after statin drug therapy four weeks of, TC/HDL-C, the number of coronary lesions and hypertension are factors for adverse cardiac events, and were statistical significance (P<0.05).