The DYSlipidemia International Study (DYSIS)-Egypt: A report on the prevalence of lipid abnormalities in Egyptian patients on chronic statin treatment

Etriby, Adel El; Bramlage, Peter; Nashar, Amany El; Brudi, Philippe

doi:10.1016/j.ehj.2013.05.003

Cited by 10 publications

(12 citation statements)

References 19 publications

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“…Similarly for diabetes, the degree of control was poor in 49% of patients attending diabetes care centers and only 30% had no complications (15). Also, the DYSlipidemia International Study (DYSIS) (16) and the WHO-PREMISE studies (17) identified important shortcomings in pharmacologic treatment and lifestyle modification, particularly in Egyptian patients with a previous stroke, despite attending outpatient clinics.…”

Section: Epidemiologymentioning

confidence: 99%

Burden of Stroke in Egypt: Current Status and Opportunities

Abd-Allah

Moustafa

2014

International Journal of Stroke

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Middle East and North Africa (MENA) countries have a diversity of populations with similar life style, dietary habits, and vascular risk factors that may influence stroke risk, prevalence, types, and disease burden. Egypt is the most populated nation in the Middle East with an estimated 85.5 million people. In Egypt, according to recent estimates, the overall prevalence rate of stroke is high with a crude prevalence rate of 963/100,000 inhabitants. In spite of disease burden, yet there is a huge evidence practice gap. The recommended treatments for ischemic stroke that are guideline include systematic supportive care in a stroke unit or stroke center is still deficient. In addition, the frequency of thrombolysis in Egypt is very low for many reasons; the major one is that the health insurance system is not covering thrombolysis therapy in nonprivate sectors so patients must cover the costs using their own personal savings; otherwise, they will not receive treatment. Another important factor is the pronounced delay in prehospital and in hospital management of acute stroke. Improvement of stroke care in Egypt should be achieved through multi and interdisciplinary approach including public awareness, physicians' education, and synergistic approach to stroke care with Emergency Medical System.

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Section: Epidemiologymentioning

confidence: 99%

Burden of Stroke in Egypt: Current Status and Opportunities

Abd-Allah

Moustafa

2014

International Journal of Stroke

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“…Inadequate cholesterol lowering in Egypt was previously reported by El Etriby et al for the first DYSIS population, with 28.3% of statin-treated very high-risk patients achieving an LDL-C level of <70 mg/dL. 18 In the Egyptian cohort of the Centralized Pan-Middle East Survey on the under-treatment of hypercholesterolemia (CEPHEUS), Reda et al found that only 10.7% of very high-risk patients, as defined by the National Cholesterol Education Program Adult Treatment Panel (NCEP ATP) III 2004 guidelines, 19 had an LDL-C level of <70 mg/dL, despite the majority being treated with a statin. 20…”

Section: Discussionmentioning

confidence: 74%

Prevalence of lipid abnormalities and cholesterol target value attainment in Egyptian patients presenting with an acute coronary syndrome

Sobhy

Etriby²,

Nashar³

et al. 2018

The Egyptian Heart Journal

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BackgroundEffective management of hyperlipidemia is of utmost importance for prevention of recurring cardiovascular events after an acute coronary syndrome (ACS). Indeed, guidelines recommend a low-density lipoprotein cholesterol (LDL-C) level of <70 mg/dL for such patients. The Dyslipidemia International Study II (DYSIS II) – Egypt was initiated in order to quantify the prevalence and extent of hyperlipidemia in patients presenting with an ACS in Egypt.MethodsIn this prospective, observational study, we documented patients presenting with an ACS at either of two participating centers in Egypt between November 2013 and September 2014. Individuals were included if they were over 18 years of age, had a full lipid profile available (recorded within 24 h of admission), and had either been taking lipid-lowering therapy (LLT) for ≥3 months at time of enrollment or had not taken LLT. Data regarding lipid levels and LLT were recorded on admission to hospital and at follow-up 4 months later.ResultsOf the 199 patients hospitalized for an ACS that were enrolled, 147 were on LLT at admission. Mean LDL-C at admission was 127.1 mg/dL, and was not significantly different between users and non-users of LLT. Only 4.0% of patients had an LDL-C level of <70 mg/dL, with the median distance to this target being 61.0 mg/dL. For the patients with LDL-C information available at both admission and follow-up, LDL-C target attainment rose from 2.8% to 5.6%. Most of the LLT-treated patients received statin monotherapy (98.6% at admission and 97.3% at follow-up), with the mean daily statin dose (normalized to atorvastatin) increasing from admission (30 mg/day) to follow-up (42 mg/day).ConclusionsDYSIS II revealed alarming LDL-C goal attainment, with none of the patients with follow-up information available reaching the target of LDL-C <70 mg/dL, either at hospital admission or 4 months after their ACS event. Improvements in guideline adherence are urgently needed for reducing the burden of cardiovascular disease in Egypt. Strategies include the effective use of statins at high doses, or combination with other agents recommended by guidelines.

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“…An additional survey-based study on NCDs risk factors in Egypt was supplemented to the shortlisted records for assessment. Finally, 8 articles from the structured searches [ 6 , 8 , 21 – 23 , 26 , 35 , 40 ], 2 nationwide survey reports from the unstructured search [ 41 , 42 ], and 1 additional study was included in the final analysis [ 16 ]. Two of the selected studies were not considered for final analysis because of the availability of the similar data in the STEPS Survey reports.…”

Section: Main Textmentioning

confidence: 99%

“…Although compliance to treatment of dyslipidemia in the CEPHEUS II study was reported at 59% [ 40 ], target LDL-C levels were achieved in only 32.5% and 34.4% of the patients as reported in the CEPHEUS I and CEPHEUS II results, respectively [ 23 , 40 ]. According to the DYSlipidemia International Study (DYSIS)-Egypt, one-third of the patients who received chronic statin treatment had control in LDL-C levels [ 21 ]. In the DYSIS II study, 73.9% of patients with ACS received treatment for dyslipidemia, whereas the proportion of patients who achieved target LDL-C levels varied within different risk categories, with 5.1% at very high risk, 27.3% at high risk, 32.3% at moderate risk, and 14.3% at low risk [ 22 ].…”

Section: Main Textmentioning

confidence: 99%

“…The management of hypertension in Egypt was affected by multiple factors such as an inconsistent approach adopted by the physicians to measure blood pressure, inadequate treatment, lower number of patients achieving target blood pressure, lower awareness of hypertension among patients, limited use of risk assessment tools to identify high-risk patients, patient noncompliance to treatment, lack of preventive centers, and absence of national registries for CVD risk factors [ 5 , 17 – 20 ]. On the other hand, despite higher awareness regarding dyslipidemia, patients were severely undertreated and were unable to reach the target lipid levels while on treatment in Egypt [ 21 , 22 ]. In addition, there was a lack of appropriate programs for the prevention and timely detection of these two CVD risk factors [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

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A semi-systematic review on hypertension and dyslipidemia care in Egypt—highlighting evidence gaps and recommendations for better patient outcomes

Reda

Ragy

Saeed³

et al. 2021

J. Egypt. Public. Health. Assoc.

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Background Both hypertension and dyslipidemia are considered as major modifiable risk factors of cardiovascular diseases (CVDs), and their prevalence in Egypt has increased in recent years. Evidence-based systematic evaluation of data on hypertension and dyslipidemia is critical for effective patient-centric management to reduce the overall risk of CVDs in Egypt. This semi-systematic review aimed to quantify and identify data gaps in the prevalence and distribution of patient journey touchpoints including awareness, screening, diagnosis, treatment, adherence, and control of hypertension and dyslipidemia to provide the basis for research prioritization, practice guidance, and health care reforms in Egypt. Main body Structured search was conducted on MEDLINE and Embase to identify articles published in English between January 2010 and December 2019 that reported key patient journey touchpoints in hypertension and dyslipidemia management. Unstructured search was conducted on public or government websites with no date restriction. Data from all sources were extracted and presented descriptively. In total, 22 studies published between 1995 and 2020 on hypertension and dyslipidemia were included in the final analyses. The prevalence of hypertension in Egypt ranged from 12.1 to 59%. Studies reported awareness (37.5% and 43.9%), diagnosis (42% and 64.7%), treatment (24% and 54.1%), and adherence to antihypertensive medication (51.9%) to be low. Furthermore, the percentage of patients who had their blood pressure controlled ranged from 8 to 53.2%. The prevalence of dyslipidemia varied in the general population (range 19.2–36.8%) but was higher in patients with acute coronary syndrome (ACS) (50.9% and 52.5%) and coronary artery disease (58.7%). A national report indicated that 8.6% of the general population was screened for dyslipidemia; however, no data was available on the diagnosis and treatment rates. Among ACS patients, 73.9% were treated for dyslipidemia. Data indicated low levels of medication adherence (59%) among dyslipidemia patients, with overall low control rates ranging from 5.1 to 34.4% depending on CVD risk in populations including ACS patients. Conclusion Data on patient journey touchpoints of hypertension and dyslipidemia are limited in Egypt, indicating the need for more systematic and high-quality evidence-based studies covering different aspects of patient-centric management for better management of CVD and its risk factors.

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The DYSlipidemia International Study (DYSIS)-Egypt: A report on the prevalence of lipid abnormalities in Egyptian patients on chronic statin treatment

Cited by 10 publications

References 19 publications

Burden of Stroke in Egypt: Current Status and Opportunities

Burden of Stroke in Egypt: Current Status and Opportunities

Prevalence of lipid abnormalities and cholesterol target value attainment in Egyptian patients presenting with an acute coronary syndrome

A semi-systematic review on hypertension and dyslipidemia care in Egypt—highlighting evidence gaps and recommendations for better patient outcomes

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