Assessment of post-myocardial infarction lipid levels and management: Results from a tertiary care hospital of Pakistan

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS World Journal of Cardiology Pub Date : 2024-05-26 DOI:10.4330/wjc.v16.i5.282
Rubina Rauf, Muhammad Ismail Soomro, Muhamman Nauman Khan, Mukesh Kumar, N. Soomro, K. Kazmi
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Abstract

BACKGROUND Lipid treatment practices and levels in post-acute myocardial infarction (AMI) patients, which are crucial for secondary prevention. AIM To evaluate the lipid treatment practices and lipid levels in post-myocardial infarction (MI) patients at a tertiary care hospital in Pakistan. METHODS In this cross-sectional study, we analyzed patients who had experienced their first AMI event in the past 3 years. We assessed fasting and non-fasting lipid profiles, reviewed statin therapy prescriptions, and examined patient compliance. The recommended dose was defined as rosuvastatin ≥ 20 mg or atorvastatin ≥ 40 mg, with target total cholesterol levels set at < 160 mg/dL and target low-density lipoprotein cholesterol (LDL-C) at < 55 mg/dL. RESULTS Among 195 patients, 71.3% were male, and the mean age was 57.1 ± 10.2 years. The median duration since AMI was 36 (interquartile range: 10-48) months and 60% were diagnosed with ST-segment elevation MI. Only 13.8% of patients were advised to undergo lipid profile testing after AMI, 88.7% of patients were on the recommended statin therapy, and 91.8% of patients were compliant with statin therapy. Only 11.5% had LDL-C within the target range and 71.7% had total cholesterol within the target range. Hospital admission in the past 12 months was reported by 14.4%, and the re-admission rate was significantly higher among non-compliant patients (37.5% vs 5.6%). Subsequent AMI event rate was also significantly higher among non-compliant patients (43.8% vs 11.7%). CONCLUSION Our study highlights that while most post-AMI patients received the recommended minimum statin therapy dose, the inadequate practice of lipid assessment may compromise therapy optimization and raise the risk of subsequent events.
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心肌梗死后血脂水平评估与管理:巴基斯坦一家三级医院的研究结果
背景 急性心肌梗死(AMI)后患者的血脂治疗方法和血脂水平对二级预防至关重要。目的 评估巴基斯坦一家三级医院心肌梗死(MI)后患者的血脂治疗方法和血脂水平。方法 在这项横断面研究中,我们分析了在过去 3 年中经历过首次急性心肌梗死事件的患者。我们评估了空腹和非空腹血脂状况,查看了他汀类药物治疗处方,并检查了患者的依从性。推荐剂量定义为罗伐他汀≥ 20 毫克或阿托伐他汀≥ 40 毫克,目标总胆固醇水平设定为< 160 毫克/分升,目标低密度脂蛋白胆固醇(LDL-C)水平设定为< 55 毫克/分升。结果 195 名患者中,71.3% 为男性,平均年龄(57.1 ± 10.2)岁。急性心肌梗死的中位持续时间为 36 个月(四分位间范围:10-48 个月),60% 的患者被诊断为 ST 段抬高型心肌梗死。只有13.8%的患者在急性心肌梗死后被建议进行血脂检测,88.7%的患者接受了推荐的他汀类药物治疗,91.8%的患者遵从他汀类药物治疗。只有 11.5% 的患者低密度脂蛋白胆固醇在目标范围内,71.7% 的患者总胆固醇在目标范围内。据报告,14.4%的患者在过去12个月中曾入院治疗,而非达标患者的再次入院率明显更高(37.5% 对 5.6%)。未达标患者的后续急性心肌梗死事件发生率也明显更高(43.8% 对 11.7%)。结论 我们的研究强调,虽然大多数急性心肌梗死后患者接受了推荐的最低他汀类药物治疗剂量,但血脂评估实践不足可能会影响治疗优化并增加后续事件的风险。
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来源期刊
World Journal of Cardiology
World Journal of Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
3.30
自引率
5.30%
发文量
54
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