ĐẶC ĐIỂM VÀ CÁC YẾU TỐ DỰ ĐOÁN ĐẠT MỤC TIÊU NON-HDL-C Ở BỆNH NHÂN BỆNH VÀNH MẠN TẠI BỆNH VIỆN NHÂN DÂN GIA ĐỊNH

Abstract

Background: Non-high-density lipoprotein cholesterol (Non-HDL-C) is an indicator that reflects the total burden of atherogenic cholesterol particles and can be easily calculated from routine lipid profile testing. Non-HDL-C is closely associated with the risk of coronary artery disease and future cardiovascular events. Lipid control is one of the essential therapeutic goals in the management of chronic coronary artery disease to prevent secondary cardiovascular events. Non-HDL-C has been recommended as a secondary treatment target following LDL-C, according to the 2019 ESC/EAS Guidelines for the Management of Dyslipidaemias. Objectives: To describe the characteristics of Non-HDL-C levels and identify predictors of Non-HDL-C target attainment in patients with chronic coronary artery disease at Nhan Dan Gia Dinh Hospital. Methods: This was a descriptive cross-sectional study conducted on 153 patients diagnosed with chronic coronary syndrome at Nhan Dan Gia Dinh Hospital from March 2025 to September 2025. All patients underwent fasting lipid profile testing, and Non-HDL-C levels were calculated. Data were collected on anthropometric characteristics, cardiovascular risk factors, comorbidities, and medications. Statistical analyses included Chi-square test, Fisher’s Exact test, Student’s t-test, Mann–Whitney U test, and both univariate and multivariate logistic regression. Results: The median and interquartile range (IQR) of Non-HDL-C levels in the study population was 2.59 (2.13 – 3.17) mmol/L. In the groups with and without Non-HDL-C target attainment, these values were 1.91 (1.69 – 2.04) mmol/L and 2.96 (2.56 – 3.65) mmol/L, respectively. Independent predictors associated with achieving the Non-HDL-C target included: normal waist-to-hip ratio (WHR), use of high-intensity statins, combination therapy of statins with another lipid-lowering agent, achievement of LDL-C target, and attainment of low triglyceride (TG) levels. Specifically, patients with a normal WHR were more likely to achieve the Non-HDL-C target compared to those with abnormal WHR (OR = 3.85; 95% CI: 1.35 – 11.00; p = 0.012). Patients on high-intensity statin therapy had a higher likelihood of achieving the target compared to those on moderate- or low-intensity statins (OR = 7.59; 95% CI: 1.13 – 50.98; p = 0.037). Combination therapy with a statin and another lipid-lowering agent significantly increased the likelihood of achieving the Non-HDL-C target compared to statin monotherapy (OR = 6.31; 95% CI: 1.21–32.79; p = 0.028). Additionally, patients who met the LDL-C target were markedly more likely to achieve the Non-HDL-C target than those who did not (OR = 49.36; 95% CI: 11.47 – 212.36; p < 0.001). Similarly, patients with low TG levels were more likely to achieve the Non-HDL-C target compared to those who did not (OR = 5.17; 95% CI: 1.73–13.66; p=0.003). Conclusions: Independent predictors associated with Non-HDL-C target attainment included normal waist-to-hip ratio (WHR), use of high-intensity statins, combination therapy with statins and other lipid-lowering agents, achievement of LDL-C target, and attainment of low triglyceride levels.