GIÁ TRỊ CỦA LDL-CHOLESTEROL VÀ HbA1C TRONG DỰ ĐOÁN BIẾN CỐ TIM MẠCH CHÍNH SAU HỘI CHỨNG VÀNH CẤP Ở BỆNH NHÂN ĐÁI THÁO ĐƯỜNG TÍP 2 TẠI BỆNH VIỆN TIM TÂM ĐỨC

Abstract

Background: LDL-cholesterol (LDL-C) plays a key role in the pathogenesis of coronary artery disease. In type 2 diabetes (T2D) patients, the disease tends to progress earlier and more severely, increasing the risk of major adverse cardiovascular events (MACEs). Objective: To evaluate the impact of LDL-C and glycemic control on MACEs after acute coronary syndrome (ACS) in patients with T2D. Methods: A retrospective cohort study was conducted on T2D patients hospitalized with ACS at Tam Duc Heart Hospital, Ho Chi Minh City, from January 1, 2021, to December 31, 2021. Results: A total of 177 patients were analyzed. After one year, 10 patients (5.6%) experienced MACEs. Only 24.9% achieved the LDL-cholesterol target and 20.3% achieved the HbA1C target. Patients who experienced MACEs had significantly higher HbA1C levels than event-free patients (p = 0.013). Although target attainment for LDL-C and HbA1C did not differ significantly between groups, the proportion with HbA1C > 8% was higher among those with MACEs (p = 0.041). Cox regression identified age and HbA1C > 8% as independent predictors of MACE (HR 4.657; 95% CI: 1.195–18.147; p = 0.027). Conclusion: Among T2D patients post-ACS, target attainment for LDL-C and HbA1C remained low. Age and HbA1C > 8% independently predicted MACEs, whereas LDL-C target attainment was not significantly associated with outcomes.