有效降脂治疗对st段抬高型心肌梗死患者预后的影响

Q4 Medicine
V. Oleynikov, L. Salyamova, O. Kvasova, V. A. Shmeleva, Y. Tomashevskaya, N. Borisova
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引用次数: 0

摘要

目标。研究在48周大剂量阿托伐他汀治疗的背景下,低密度脂蛋白胆固醇(LDL)达到和维持目标水平(TL)对生活质量、运动耐量、中央和外周血压参数、心血管不良事件的影响。设计和方法。共纳入141例st段抬高急性心肌梗死患者。48周内,患者接受阿托伐他汀40 - 80mg /天的治疗。术后第7-9天、第24周和第48周进行全面检查。192周后,对终点进行评估。研究共完成125人(88.7%)。患者被分为两组:“А”(n = 41) -在24周和48周后LDL达到低密度脂蛋白水平;“PA”(n = 35) -在两次访问中的一次中部分达到LDL的TL;“NA”组(n = 49) -未达到TL。根据明尼苏达问卷,“PA”组的慢性心力衰竭症状增加(+ 53.5 %;p = 0.009)和“NA”(+ 75%;P = 0.001)。在“PA”组的压压测量中,主动脉脉压升高的人数增加。在“NA”组中,诊断为中央主动脉收缩压正常和脉压升高的病例增加。192周后,“PA”组和“NA”组的终点频率为38.1%,而“А”组的终点频率为17.1% (p = 0.017);优势比为3,0(95%置信区间1,2 - 7,5)。我们的研究表明,达到并维持低密度脂蛋白治疗48周的患者的临床表现和预后最有利。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The impact of effective lipid-lowering therapy on the prognosis in patients who have suffered ST-segment elevation myocardial infarction
Objective. To study the dynamics of quality of life, exercise tolerance, parameters of central and peripheral blood pressure, adverse cardiovascular events depending on the achievement and maintenance of the target level (TL) of low-density lipoprotein cholesterol (LDL) against the background of 48-week high-dose therapy with atorvastatin.Design and methods. In total, 141 patients with acute myocardial infarction with ST-segment elevation were included. Within 48 weeks patients received atorvastatin 40–80 mg/day. A comprehensive examination was performed on days 7–9, after 24 and 48 weeks. After 192 weeks the endpoints were assessed.Results. The study was completed by 125 people (88,7 %). The patients were divided into groups: “А” (n = 41) — with achieved TL of LDL after 24 and 48 weeks; “PA” (n = 35) — partially achieved TL of LDL — on one of two visits; “NA” (n = 49) — not achieved TL. According to the Minnesota questionnaire, the symptoms of chronic heart failure increased in the groups “PA” (+53,5 %; p = 0,009) and “NA” (+75 %; p = 0,001). During applanation tonometry in the “PA” group, the number of people with elevated pulse pressure in the aorta increased. In the “NA” group, an increase in cases of normal and elevated central aortic systolic, pulse pressure was diagnosed. After 192 weeks the frequency of endpoints in the “PA” and “NA” groups was 38,1 % vs 17,1 % in the “А” group (p = 0,017); the odds ratio was 3,0 (95 % confidence interval 1,2–7,5).Conclusions. Our study demonstrated the most favorable clinical profile and prognosis in patients who achieved and maintained LDL for 48 weeks treatment.
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来源期刊
Arterial Hypertension (Russian Federation)
Arterial Hypertension (Russian Federation) Medicine-Cardiology and Cardiovascular Medicine
CiteScore
0.90
自引率
0.00%
发文量
38
期刊介绍: The main aims of the Journal include collecting and generalizing the knowledge in hypertensiology; education and professional development of cardiologists and medical doctors of other specialties, who deal with different issues regarding diagnostics, management and prevention of hypertension in both clinical practice and research. The Journal also calls attention to the most urgent and up-to-date questions in hypertensiology, cardiology and related sciences. There are additional objectives, such as increasing the availability, accessibility and recognition of Russian medical scientific achievements at the international level by improving the quality of the publication and the way they are presented; enabling the exchange of opinions and information between scientists and their wider communication. The main criteria for publication selection fit with the mentioned objectives and include currency, singularity, scientific and practical novelty, applied relevance etc.
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