NGHIÊN CỨU ĐẶC ĐIỂM RỐI LOẠN LIPID MÁU Ở BỆNH NHÂN HỘI CHỨNG MẠCH VÀNH CẤP TẠI BỆNH VIỆN NHÂN DÂN GIA ĐỊNH

Abstract

Background: Acute coronary syndrome (ACS) remains the leading cause of cardiovascular mortality worldwide. Dyslipidemia is both a pathological risk factor and an important therapeutic target in ACS management. The dyslipidemia profile in ACS patients varies significantly across centers and countries. Objectives: The study aimed to investigate the characteristics of dyslipidemia in patients diagnosed with ACS at Nhan Dan Gia Dinh Hospital. Methods: This cross-sectional descriptive study was conducted at Nhan Dan Gia Dinh Hospital from February 2024 to May 2024. Inclusion criteria comprised patients diagnosed with ACS as per the Fourth Universal Definition of ACS and who underwent fasting blood lipid profile analysis within 24 hours of admission, including total cholesterol, LDLc, HDLc, and triglycerides. Results: Among 401 ACS patients admitted during the study period, the mean lipid profile values recorded were as follows: total cholesterol 4,95 ± 2,52 mmol/L, triglycerides 2,34 ± 1,39 mmol/L, LDLc 2,87 ± 1,40 mmol/L, HDL-c 1,25 ± 1,22 mmol/L, and non-HDL-c 3,76 ± 2,53 mmol/L. Dyslipidemia was present in 76,1% of the patients. Specific types of dyslipidemia included elevated total cholesterol in 27.4% (110 patients), elevated triglycerides in 55,4% (222 patients), elevated LDL-cholesterol in 25,9% (104 patients), reduced HDL-cholesterol in 46,1% (185 patients), and elevated non-HDL-cholesterol in 60,6 % (243 patients). Notable differences in lipid abnormalities were observed between STEMI and NSTEMI/UA patients, with significant differences in the prevalence of elevated total cholesterol and combined LDL-cholesterol/triglyceride elevations (p-values of 0,015 and 0,026, respectively). Subgroup analysis revealed that elderly patients (≥ 60 years) with elevated total cholesterol or reduced HDL-cholesterol were more likely to present with STEMI, with odds ratios (ORs) of 1,6 (95% CI: 1.07–2,38, p < 0,05) and 1.34 (95% CI: 1.05–1,72, p < 0,05), respectively. Male patients with elevated total cholesterol or combined LDL-cholesterol/triglyceride elevation exhibited markedly higher risks of STEMI, with ORs of 1,76 (95% CI: 1.17–2.65, p < 0,05) and 1,61 (95% CI: 1,00–2,58, p < 0,05), respectively. Smoking history combined with elevated total cholesterol increased the risk of STEMI by 1,73-fold (95% CI: 1,06–2,84, p < 0,05). Furthermore, a history of hypertension coupled with elevated total cholesterol, elevated LDL-cholesterol, or combined LDL-cholesterol/triglyceride elevation was associated with higher STEMI risks, with ORs of 1,56 (95% CI: 1,10–2,20, p < 0,05), 1,54 (95% CI: 1,08–2,20, p < 0,05), and 1,63 (95% CI: 1,07–2,48, p < 0,05), respectively. Conclusions: The majority of ACS patients admitted during the study period exhibited dyslipidemia, with the most common abnormalities being elevated non-HDL-cholesterol, elevated triglycerides, and elevated LDL-cholesterol. Clinical risk factors and dyslipidemia profiles demonstrated significant variations between STEMI and NSTEMI/UA groups.