| BackgroundThe population of Chinese patients with atherosclerotic cardiovascular disease(ASCVD)is increasing year by year,and dyslipidemia is one of the major risk factors.The decrease of LDL-C level is one of the main measures to prevent coronary events.According to the dyslipidemia guidelines,the current LDL-C compliance rate is not desirable,especially for the high-risk patients' group.Statins are the first choice in lipid-lowering therapy.The side effects of statins are myalgia,elevated muscle enzymes,and abnormal liver function.Chinese patients usually take moderate doses of statins,but further research is needed to clarify questions concerning the safety of Statins.ObjectiveThe aim of this study was to investigate the percentage of patients whose blood lipid reached the standard and the safety of statins in patients with coronary heart disease after being treated with percutaneous coronary intervention(PCI)in real clinical practice.MethodFrom January 2014 to December 2018,801 patients with coronary heart disease after PCI,including 610 males and 191 females,were regularly treated with moderate doses of statins for more than 3 months and were regularly followed up in the Cardiovascular Internal Medicine Outpatient Department of our hospital.Their blood lipid status was recorded.According to the 2016 Chinese guideline for the management of dyslipidemia in adults,the subjects of this study were all very high-risk groups.The target of blood lipid control: patients with baseline LDL-C>1.8 mmol/L,and the target was LDL-C<1.8 mmol/L;baseline LDL-C?1.8 mmol/L,and LDL-C was reduced by about 30%,non-HDL-<2.6 mmol/L.According to the target,we determined whether the blood lipid reached the standard level,and calculated the proportion of people who meet the standard,therefore analyzed the possible factors affecting the standard and observed the adverse effects during the statin treatment.Result1.For LDL-C ?1.8mmol/L,the total compliance rate of LDL-C in 801 very high-risk patients was 49.1%.The compliance rate of patients with baseline LDL-C>1.8 mmol/L was 57.5% and the compliance rate of patients with baseline LDL-C?1.8mmol/L was 17.3%;the compliance rate of non-HDL-C was 67.5%.2.In this study,independent factors affecting LDL-C compliance rate included LDL-C baseline level and postoperative low-fat diet.3.All patients in this study took moderate-intensity statins.During the lipid-lowering process,the majority of patients tolerated well 5 out of 801 patients felt muscle pain,therefore the incidence was 0.62%,including 4 cases with normal muscle enzymes level and 1 case with significantly elevated muscle enzymes level.After discontinuing being treated with the drug,the patients' muscle zymogram was reexamined,and CK was found to have been reduced to the normal level.10 patients had abnormal liver function(AST,ALT > 3 times ULT),but when the treatment was discontinued,the patient's liver enzymes gradually returned to the normal level.4.Whether having comorbid diabetes or not,the patients' fasting blood glucose was increased slightly after 12 months of statin treatment.Conclusion1.In the real clinical practice,patients with coronary heart disease after PCI routinely take a moderate dose of statins to lower blood lipid,however the LDL-C compliance rate is low.2.There are many factors affecting the compliance rate,but independent factors are LDL-C baseline level and postoperative low-fat diet.3.Taking medium doses of statins is relatively safe in clinical practice.Adverse effects are rare and adverse effects including myalgia,elevated muscle enzymes,and abnormal liver function can be reversed after discontinuing the drug,but the fasting blood glucose index is still elevated.4.For the very high-risk groups,the administration of usage of statins for lipid regulation needs to be further strengthened.To reduce the influence of controllable factors,some patients must be treated with high-intensity statins to monitor the occurrence of adverse effects. |
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