冠心病患者血脂达标现状及危险因素分析

Q: What are the key findings of this study?

High statin adherence was the strongest independent factor associated with LDL-C target attainment in coronary heart disease patients.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Coronary heart disease (CHD) (n=1200). Intervention: High statin adherence and nurse-led closed-loop management (electronic medical record alert plus monthly structured nursing telephone follow-up) vs. Low statin adherence and routine outpatient follow-up every 3 months. Primary outcome: LDL-C target attainment (<1.8 mmol/L) (OR 3.20, 95% CI 2.20-4.65, p=<0.001).

Q: What does this research mean for the field?

Nurse-led closed-loop management improves LDL-C target attainment and reduces cardiovascular events, rehospitalizations, and all-cause mortality in coronary heart disease patients compared with routine follow-up. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To investigate the status and independent risk factors of lipid target attainment (LDL-C < 1.8 mmol/L) in coronary heart disease, and evaluate the effect of nurse-led closed-loop management.

理新开

doi:10.37155/2717-5669-0705-34

January 1, 2026国际全科医学Open Access

冠心病患者血脂达标现状及危险因素分析

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Key result

High statin adherence linked to ~3.2-fold higher odds of LDL-C target attainment in CHD.

OR 3.20
95% CI 2.20-4.65
P<0.001
n=1,200

Why the study?

The study aimed to investigate the current status and independent risk factors of lipid target achievement in coronary heart disease patients, and to evaluate the effect of nurse-led closed-loop management on LDL-C and cardiovascular outcomes.

Does a nurse-led closed-loop management pathway with electronic alerts and structured follow-up improve LDL-C goal attainment (<1.8 mmol/L) and cardiovascular outcomes compared to routine physician-led outpatient follow-up in patients with coronary heart disease?

Key Points

To investigate the status and independent risk factors of lipid target attainment (LDL-C < 1.8 mmol/L) in coronary heart disease, and evaluate the effect of nurse-led closed-loop management.
Analyzed 1200 real-world coronary heart disease cases enrolled between June 2023 and June 2026, categorized by baseline LDL-C < 1.8 mmol/L into an observation group (nurse-led structured follow-up with electronic medical record alerts, n=600) and a control group (routine outpatient follow-up, n=600).
Assessed independent determinants of LDL-C target achievement using multivariable logistic regression after adjusting for sex and disease course, alongside subgroup analyses of comorbidity burden and lifestyle factors.
Multivariable logistic regression identified older age (OR = 1.05, 95% CI: 1.02–1.08, P = 0.002), hypertension (OR = 1.82, 95% CI: 1.25–2.65, P = 0.002), diabetes (OR = 2.15, 95% CI: 1.48–3.12, P < 0.001), high statin adherence (OR = 3.20, 95% CI: 2.20–4.65, P < 0.001), and higher BMI (OR = 1.12, 95% CI: 1.05–1.20, P = 0.001) as independent factors associated with LDL-C target attainment.
Lipid target attainment rates decreased progressively with comorbidity burden, falling from 45.0% (270/600) in isolated coronary heart disease to 38.1% (320/840) with hypertension, 30.0% (144/480) with diabetes, and 20.0% (48/240) in triple comorbidity (P < 0.05).
Healthy behaviors were associated with higher target attainment, including non-smoking (150/300 vs. 90/300, P = 0.002), exercise ≥ 3 times per week (180/300 vs. 120/300, P = 0.005), and strict low-fat diet (200/300 vs. 100/300, P < 0.001).

Study Design

Type

Cohort (n=1,200)

Multicenter

No

Structured PICO

Does a nurse-led closed-loop management pathway with electronic alerts and structured follow-up improve LDL-C goal attainment (<1.8 mmol/L) and cardiovascular outcomes compared to routine physician-led outpatient follow-up in patients with coronary heart disease?

P

Population

1,200 adults with coronary heart disease (mean age 62.5 years, 40% female) at a single center in China, divided into two groups of 600 based on LDL-C <1.8 mmol/L.

E

Exposure

Nurse-led closed-loop management ('lipid target - follow-up - intervention') featuring electronic medical record (EMR) automatic alerts for LDL-C non-achievers, monthly structured telephone follow-ups by responsible nurses (statin adherence reminders, individualized diet/exercise guidance, psychological support), standardized tracking in electronic health records, and medical consortium referral for drug intolerance or worsening comorbidities.

C

Comparator

Routine outpatient follow-up and health education every 3 months led by the attending physician, providing basic medication and general lifestyle guidance without specialized nursing intervention or electronic alerts.

O

Outcome

LDL-C goal attainment status (defined as LDL-C < 1.8 mmol/L according to the 2023 Chinese Guidelines for Lipid Management) and its independent risk factors.surrogate

Main Result

Odds Ratio: 3.2 (95% CI 2.2–4.65)

p-value: p=<0.001

In patients with coronary heart disease, statin adherence, comorbidity burden, age, BMI, and lifestyle habits significantly influence LDL-C goal attainment (<1.8 mmol/L), supporting the use of nurse-led closed-loop management to improve lipid control.

Limitations

Single-center study with limited generalizability
Did not track long-term stability of lipid target attainment
Cost-effectiveness and accessibility across different institutions require further evaluation
Single-center study with limited generalizability (poor extrapolability)
Did not track long-term stability of lipid goal attainment
Cost-effectiveness and accessibility across different medical institutions remain to be evaluated

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Implication

High statin adherence strongly predicts LDL-C target attainment; extends modifiable-factor evidence but leaves open nurse-led pathway efficacy in trials.

Abstract

理新开（天津华兴医院）目的：探究冠心病患者血脂达标现状和独立危险因素，并分析护理主导闭环管理对于LDL-C及心血管结局的干预作用。方法：选择1200例冠心病的真实世界病例，按LDL-C < 1.8mmol/L分组，观察组进行电子病历预警并开展护理结构化的随访干预，对照组行常规门诊随访，应用多变量Logistic回归分析危险因素，比较分层资料以及心血管结局。结果：他汀依从性、合并症、年龄、BMI是血脂达标的独立因素，依从性差、合并症多则达标率低，健康的生活方式有利于血脂控制；闭环管理可以减少心血管事件、再住院及全因死亡，优化了风险评分和运动耐量。结论：护理闭环管理能够改善极高危冠心病患者的血脂及远期心血管结局，适合于在基层慢病中推广应用。目的：探究冠心病患者血脂达标现状和独立危险因素，并分析护理主导闭环管理对于LDL-C及心血管结局的干预作用。方法：选择1200例冠心病的真实世界病例，按LDL-C < 1.8mmol/L分组，观察组进行电子病历预警并开展护理结构化的随访干预，对照组行常规门诊随访，应用多变量Logistic回归分析危险因素，比较分层资料以及心血管结局。结果：他汀依从性、合并症、年龄、BMI是血脂达标的独立因素，依从性差、合并症多则达标率低，健康的生活方式有利于血脂控制；闭环管理可以减少心血管事件、再住院及全因死亡，优化了风险评分和运动耐量。结论：护理闭环管理能够改善极高危冠心病患者的血脂及远期心血管结局，适合于在基层慢病中推广应用。

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Cite This Study

理新开 (2026) conducted a cohort in Coronary heart disease (CHD) (n=1,200). High statin adherence and nurse-led closed-loop management (electronic medical record alert plus monthly structured nursing telephone follow-up) vs. Low statin adherence and routine outpatient follow-up every 3 months was evaluated on LDL-C target attainment (<1.8 mmol/L) (OR 3.20, 95% CI 2.20-4.65, p=<0.001). High statin adherence was the strongest independent factor associated with LDL-C target attainment in coronary heart disease patients.

synapsesocial.com/papers/6af354fd5b67d29976ea0824 https://doi.org/10.37155/2717-5669-0705-34

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冠心病患者血脂达标现状及危险因素分析

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

冠心病患者血脂达标现状及危险因素分析

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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