TỶ LỆ VÀ CÁC YẾU TỐ DỰ ĐOÁN KHÔNG ĐẠT MỤC TIÊU LDL-C VÀ HS-CRP Ở BỆNH NHÂN SAU NHỒI MÁU CƠ TIM CẤP TẠI BỆNH VIỆN TIM TÂM ĐỨC

Abstract

Background: High-sensitivity C-reactive protein (hs-CRP) is an independent and widely recognized biomarker of systemic inflammation, closely associated with the incidence of cardiovascular events and adverse outcomes following acute coronary syndrome. Achieving target levels for both LDL-C and hs-CRP is significantly associated with improved clinical outcomes in patients after acute myocardial infarction. Objectives: To determine the proportion and predictors of failure to achieve target levels of LDL-C and hs-CRP in patients after acute myocardial infarction at Tam Duc Heart Hospital. Methods: A descriptive cross-sectional study was conducted on 93 patients who had experienced acute myocardial infarction at least one month prior, at Tam Duc Heart Hospital, from September 2024 to June 2025. Patients were assessed for hs-CRP and LDL-C levels, and data on anthropometric characteristics, comorbidities, and treatment were recorded. Statistical analyses included Chi-square test, independent Student's t-test, Mann-Whitney U test, and both univariate and multivariate logistic regression. Results: Among the patients, 24.73% had hs-CRP levels ≥ 2 mg/L. The proportion of patients not achieving the LDL-C target was 43.01%, while 56.99% met the target. A total of 48.39% of patients achieved both LDL-C and hs-CRP targets simultaneously, whereas 51.61% failed to reach at least one of the two targets. Specifically, 16.13% did not meet either target, 26.88% failed to achieve only the LDL-C target, and 8.60% failed to achieve only the hs-CRP target. Patients failing to achieve the hs-CRP target were more frequently those with chronic kidney disease, those receiving sacubitril/valsartan therapy, and had a higher proportion of LDL-C target non-achievement. Additionally, the group not reaching the LDL-C target showed a higher prevalence of diabetes mellitus and hs-CRP target failure compared to the group that met the LDL-C goal. Compared to patients who failed to achieve both LDL-C and hs-CRP targets, those who achieved one or both targets had a higher rate of angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) use—this was identified as an independent predictor with statistical significance. Conclusions: The proportions of patients failing to achieve hs-CRP, LDL-C, and both targets were 24.73%, 43.01%, and 16.13%, respectively. Predictors of failure to achieve the hs-CRP target included chronic kidney disease, use of sacubitril/valsartan, and failure to achieve the LDL-C target. Diabetes mellitus and failure to achieve the hs-CRP target were associated with failure to meet the LDL-C goal. Compared to patients who failed to achieve both hs-CRP and LDL-C targets, those who achieved one or both targets had a higher rate of angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) use—this was identified as an independent predictor with statistical significance.