ST segment elevation myocardial infarction (STEMI) patients are more likely to achieve lipid-lowering treatment goals

Abstract

Statin nonadherence or discontinuation is associated with increased cardiovascular events. Many factors related to the physicians or the patients are influential in this. We aimed to compare the compliance with statin therapy between the patients who first presented with ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), and unstable angina pectoris (UA) based on the target achievement according to the current dyslipidemia guidelines.We retrospectively acquired all the information about demographic characteristics, in-hospital revascularization procedures, prescribed treatments, and index and up to 6-month follow-up laboratory results of the first acute coronary syndrome patients. Acute coronary syndrome patients were divided into 3 groups as STEMI, NSTEMI, and UA.The STEMI group consisted of 260 patients, NSTEMI group consisted of 560 patients, and UA group consisted of 206 patients. Seventy-six percent of patients underwent percutaneous coronary interventions, 18.3% were managed medically, and 5.7% were referred for coronary artery bypass grafting. There was a significant decrease in low-density lipoprotein-cholesterol (LDL-C) values with the statin treatment at the follow-up in all 3 groups (for all P < .001). In the STEMI group, the percentage of those achieving the target LDL-C level was significantly higher than those who did not achieve the target according to both The American College of Cardiology/American Heart Association (ACC/AHA) and European Society of Cardiology dyslipidemia guidelines. The LDL-C target achievement rates were also higher in the STEMI group than in the NSTEMI and UA groups.Our study concluded that statin treatment goals were more attained in STEMI patients than NSTEMI and UA. All physicians should encourage lifelong intensive statin treatment in UA and NSTEMI patients such as STEMI patients.

Reply to the letter to the editor: [Comment on “The relationship between atherogenic index of plasma and no-reflow in patients with acute ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention]

“…There was no noticeably difference between the two study results. Moreover, in recent studies whose population was STEMI patients in Turkey, the mean level of measured lipoprotein levels were similar with our measurement with a difference of ± 5% [5][6][7]. Additionally, our study had relatively small sample size, and the patients' demographic and laboratory findings could not be generalized to the whole population.…”

Feasibility and validity of Ecological Momentary Assessment in patients with acute coronary syndrome

“…While the higher prevalence of acute coronary syndrome in men is also reflected in the current sample, replicating these findings in samples including a larger percentage of women would permit the examination of potential sex differences. In comparison with other studies [25], there was a high proportion of ST elevation in our sample. This may be explained by the fact that very few hospitals with equipment to perform coronary angiography exist in the area where the study was conducted, and therefore patients with ST elevation were referred to this teaching hospital at greater proportions than in other areas.…”

A Narrative Review and Expert Panel Recommendations on Dyslipidaemia Management After Acute Coronary Syndrome in Countries Outside Western Europe and North America

“…For example, 57.3% of patients treated with high-potency statins in a study in Hong Kong ( n = 2850) did not achieve LDL-C goal 12 months post ACS compared with 63.4% of patients treated with non-high-potency statins [ 28 ]. Consistent findings were noted in a study of 1026 patients with ACS in Turkey, in which patients treated with high-intensity statin therapy were more likely to achieve LDL-C targets compared with patients prescribed lower doses of statins; however, LDL-C goal achievement was still low (≤ 45.2%) [ 29 ]. A further study of 2034 Chinese patients with ACS receiving LMT but not at LDL-C goal reported that 71.5% of these patients were receiving intensive statin therapy [ 30 ].…”