Clinical Application Of Blood Lipid Control In Patients With Coronary Heart Disease In HengYang

Objective: According to the target value standards of the cardiovascular risk group at high risk in the 2016 Guidelines for the Prevention and Treatment of Dyslipidemia in Chinese Adults and the 2019 Guidelines for the Management of Dyslipidemia in ESC / EAS,observe the blood lipid control compliance of patients with coronary heart disease in Hengyang area.Methods: A total of 150 patients hospitalized in the Department of Cardiology of The First Affiliated Hospital of University of South China from February 2017 to September 2019 were collected.Collect the patient's basic data,medical history data,laboratory examination and coronary angiography results.According to the 2016 "Guidelines for the Prevention and Treatment of Dyslipidemia in Chinese Adults",the target values of the cardiovascular risk group are LDL-C<1.8 mmol/L(70 mg/dL),Non-HDL-C<2.6 mmol/L(100 mg/dL),"2019 ESC/EAS dyslipidemia management guidelines" target values are LDL-C<1.4 mmol/L(55mg/dL),Non-HDL-C <2.2 mmol/L(85 mg/dL),Statistics on the compliance rates of patients with LDL-C and Non-HDL-C under the two standards;at the same time,they were grouped according to the patients' LDL-C and Non-HDL-C values:(1)Group A1: LDL-C>1.8mmol /L(70mg/dL),Group A2: 1.4mmol/L(55mg/dL)?LDL-C <1.8mmol/L(70mg/dL),Group A3: LDL-C<1.4mmol/L(55mg/dL);(2)Group B1: Non-HDL-C> 2.6mmol/L(100mg/dL),Group B2: 2.2mmol/L(85mg/dL)?Non-HDL-C <2.6mmol/L(100mg/dL),Group B3: Non-HDL-C <2.2mmol/L(85mg/dL).According to two grouping methods,comparative analysis of patient data.All enrolled patients were interviewed or followed up by telephone 6 months after discharge from the hospital to record the major adverse cardiac events(Cardiogenic rehospitalization and cardiogenic death)and adverse events of hemorrhagic stroke,new-onset diabetes,and new-onset malignancies.Results: 1.The rate of secondary prevention of blood lipids in patients with coronary heart disease is low: According to the 2016 "Guidelines for the Prevention and Treatment of Dyslipidemia in Chinese Adults",LDL-C<1.8mmol/L(70mg/dL)58 people(38.7%),Non-HDL-C<2.6mmol/L(100mg/dL)86 people(53.7%);according to the 2019 "ESC/EAS Management Guidelines for Dyslipidemia" LDL-C <1.4 mmol/L(55mg/dL)28 people(18.7%),Non-HDL-C <2.2 mmol/L(85mg/dL)63 people(42%).2.There were no statistically significant differences in data such as gender,age,blood pressure(systolic blood pressure,diastolic blood pressure),smoking history,diabetes history,hypertension history among the three groups A1-A3(P>0.05);among patients with decreased LDL-C,the BMI value and the prevalence of acute coronary syndrome decreased(P<0.01).There were no statistically significant differences in the data of gender,blood pressure(systolic blood pressure,diastolic blood pressure),smoking history,hypertension history among the three groups B1-B3(P> 0.05);Non-HDL-C levels in elderly patients were lower,and the differences were of statistically academic significance(P<0.05);When Non-HDL-C level was lower,BMI value,diabetes,acute coronary syndrome prevalence were lower,the difference was statistically significant(P <0.05).3.Coronary angiography: no significant correlation between LDL-C,Non-HDL-C levels and the number of coronary artery lesio-ns(single or multiple branches),occlusion(occlusion or non-occlusion)in patients with coronary heart disease(P>0.05).4.During the follow-up,no adverse events such as hemorrhagic stroke,new diabetes,and new malignant tumor.Univariate analysis of MACE events showed that the patients in group A3 and in group B3 had a lower risk of MACE events and the difference was st-atistically significant(P<0.01);Multivariate analysis showed that the levels of LDL-C,Non-HDL-C were positively correlative with major cardiovascular adverse events(95%CI,P<0.05).Conclusion: Patients with coronary heart disease in Hengyang have a lower rate of achieving secondary blood lipids;controlling LDL-C levels below 1.4mmol/L(55mg/dL)and Non-HDL-C levels below 2.2mmol/L(85mg/dL)is safer and more beneficial to the patients with coronary heart disease in Hengyang area.