Revista de Investigación Clínica (Jan 2021)

Evaluation of Low-density Lipoprotein Cholesterol Target Attainment Rates According to the 2016 and 2019 European Society of Cardiology/ European Atherosclerosis Society Dyslipidemia Guidelines for Secondary Prevention in Patients with Acute Myocardial Infarction

  • Barış Şimşek,
  • Duygu İnan,
  • Tufan Çınar,
  • Ahmet Cagdas-Yumurtaş,
  • Veysel Ozan-Tanık,
  • Gonul Zeren,
  • İlhan İlker-Avcı,
  • Can Yücel-Karabay,
  • Barış Güngör,
  • Lale Tokgozoğlu

DOI
https://doi.org/10.24875/RIC.21000152
Journal volume & issue
Vol. 73, no. 6

Abstract

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Background: High-intensity statin (HIS) therapy is widely recommended for secondary prevention after an acute myocardial infarction (AMI). The 2019 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) dyslipidemia guidelines have lowered the target low-density lipoprotein cholesterol (LDL-C) level, which necessitates a more frequent use of nonstatin therapies. Objectives: The objectives of the study were to investigate the rate of LDL-C target attainment for secondary prevention in AMI patients. Methods: This retrospective investigation included 1360 patients diagnosed with AMI in a tertiary heart center. Lipid parameters were collected within 24 h of admission and within 1 year after discharge. The medications used were retrieved from medical records, and the lowest LDL-C levels after statin treatment were used to assess the effectiveness of the therapy. LDL-C target attainment was defined according to the 2016 ESC/EAS dyslipidemia guidelines as an LDL-C level of < 70 mg/dL and a ≥ 50% reduction from baseline. In addition, the rate of LDL-C target attainment according to the 2019 ESC/EAS guidelines was defined as an LDL-C level of < 55 mg/dL and a ≥ 50% reduction from baseline. Results: In total, 502 (36.9%) and 247 (18.2%) patients reached the LDL-C targets according to the 2016 and 2019 ESC/EAS guidelines, respectively. The admission LDL-C levels were significantly lower and HIS treatment was used more frequently in patients who subsequently attained the LDL-C goal. Remarkably, 461 (34%) patients failed to reach the LDL-C goals despite HIS treatment. Only 27 (1.9%) patients were prescribed ezetimibe. Conclusion: The rate of LDL-C goal attainment in AMI patients was low, which indicates the need for combination statin and non-statin lipid-lowering therapies.

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