Analysis of Low-Density Lipoprotein Cholesterol Target Achievement Rate and Influencing Factors in Secondary Prevention of Ischemic Stroke

ZHENG Yexiang; HUANG Genliang; WU Guanghui

doi:10.13919/j.issn.2095-6274.ZHJY202411011

Abstract：Objective To analyze the achievement rate of low-density lipoprotein cholesterol (LDL-C) targets and its influencing factors in the secondary prevention of ischemic stroke among high-risk populations par-ticipating in the "In-Hospital Comprehensive Intervention Program for Stroke High-Risk Groups" at Ningde Hos-pital. Methods A total of 2,713 acute ischemic stroke patients who were enrolled in the intervention program between January 2018 and December 2021,with the onset of stroke occurring within 14 days of hospitalization,were included in the study. Additionally,1,678 non-cardiogenic ischemic stroke patients who completed 12 months of follow-up were included. LDL-C target achievement was defined as ≤1.8 mmol/L or a reduction of ≥50％. Pa-tients were divided into two groups:the LDL-C target group (n=442) and the non-target group (n=1,236). The basic characteristics of the two groups were compared,and factors influencing LDL-C target achievement and lipid-low-ering treatment were screened using logistic regression analysis. Results The LDL-C target group had a higher incidence of previous cerebral infarction,a higher detection rate of carotid artery stenosis,a higher proportion of patients with poor functional prognosis at the 12-month follow-up,a higher rate of lipid-lowering treatment,and a higher proportion of family care compared to the non-target group. The detection rate of dyslipidem-ia was significantly lower in the LDL-C target group (P<0.05). Significant differences in work status dur-ing follow-up were observed between the two groups (P<0.05). Regression analysis showed that lipid-low-ering treatment(OR=2.683,95％CI:1.945-3.703),dyslipidemia(OR=0.758,95％CI:0.587-0.979),and poor function-al prognosis (OR=1.393,95％CI:1.104-1.759) were all significant factors influencing LDL-C target achievement (P<0.05). Additionally,coronary artery disease,the number of vascular risk factors (VRFs),and carotid artery ste-nosis were identified as factors influencing lipid-lowering treatment (P<0.05). Conclusion The "Comprehensive Intervention Program" can improve the LDL-C target achievement rate in secondary prevention of stroke,though the rate remains relatively low. Lipid-lowering treatment is the most significant factor influencing LDL-C target achievement. The presence of coronary artery disease,carotid artery stenosis,and a higher number of vascular risk factors contribute to better lipid-lowering treatment outcomes. Conversely,secondary prevention lipid management should be strengthened for stroke patients without these risk factors.