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Medical and psychosocial factors and unfavourable low-density lipoprotein cholesterol control in coronary patients.
Munkhaugen, John; Sverre, Elise; Otterstad, Jan E; Peersen, Kari; Gjertsen, Erik; Perk, Joep; Gullestad, Lars; Moum, Torbjørn; Dammen, Toril; Husebye, Einar.
Afiliación
  • Munkhaugen J; 1 Department of Medicine, Drammen Hospital, Norway.
  • Sverre E; 1 Department of Medicine, Drammen Hospital, Norway.
  • Otterstad JE; 2 Department of Behavioural Sciences in Medicine and Faculty of Medicine, University of Oslo, Norway.
  • Peersen K; 3 Department of Medicine, Vestfold Hospital, Norway.
  • Gjertsen E; 3 Department of Medicine, Vestfold Hospital, Norway.
  • Perk J; 4 Department of Cardiology, Oslo University Hospital Rikshospitalet and Faculty of Medicine, University of Oslo, Norway.
  • Gullestad L; 1 Department of Medicine, Drammen Hospital, Norway.
  • Moum T; 5 Department of Cardiology, Public Health Department, Linnaeus University, Kalmar, Sweden.
  • Dammen T; 4 Department of Cardiology, Oslo University Hospital Rikshospitalet and Faculty of Medicine, University of Oslo, Norway.
  • Husebye E; 2 Department of Behavioural Sciences in Medicine and Faculty of Medicine, University of Oslo, Norway.
Eur J Prev Cardiol ; 24(9): 981-989, 2017 06.
Article en En | MEDLINE | ID: mdl-28196429
Objective Understanding the determinants of low-density lipoprotein cholesterol (LDL-C) control constitutes the basis of modelling interventions for optimal lipid control and prognosis. We aim to identify medical and psychosocial (study) factors associated with unfavourable LDL-C control in coronary patients. Methods A cross-sectional explorative study used logistic and linear regression analysis to investigate the association between study factors and LDL-C in 1095 patients, hospitalized with myocardial infarction and/or a coronary revascularization procedure. Data were collected from hospital records, a comprehensive self-report questionnaire, clinical examination and blood samples after 2-36 months follow-up. Results Fifty-seven per cent did not reach the LDL-C target of 1.8 mmol/l at follow-up. Low socioeconomic status and psychosocial factors were not associated with failure to reach the LDL-C target. Statin specific side-effects (odds ratio 3.23), low statin adherence (odds ratio 3.07), coronary artery by-pass graft operation as index treatment (odds ratio 1.95), ≥ 1 coronary event prior to the index event (odds ratio 1.81), female gender (odds ratio 1.80), moderate- or low-intensity statin therapy (odds ratio 1.62) and eating fish < 3 times/week (odds ratio 1.56) were statistically significantly associated with failure to reach the LDL-C target, in adjusted analyses. Only side-effects (standardized ß 0.180), low statin adherence ( ß 0.209) and moderate- or low-intensity statin therapy ( ß 0.228) were associated with LDL-C in continuous analyses. Conclusions Statin specific side-effects, low statin adherence and moderate- or low-intensity statin therapy were the major factors associated with unfavourable LDL-C control. Interventions to improve LDL-C should ensure adherence and prescription of sufficiently potent statins, and address side-effects appropriately.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Inhibidores de Hidroximetilglutaril-CoA Reductasas / Dislipidemias / Cumplimiento de la Medicación / LDL-Colesterol / Infarto del Miocardio Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies País/Región como asunto: Europa Idioma: En Revista: Eur J Prev Cardiol Año: 2017 Tipo del documento: Article País de afiliación: Noruega Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Inhibidores de Hidroximetilglutaril-CoA Reductasas / Dislipidemias / Cumplimiento de la Medicación / LDL-Colesterol / Infarto del Miocardio Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies País/Región como asunto: Europa Idioma: En Revista: Eur J Prev Cardiol Año: 2017 Tipo del documento: Article País de afiliación: Noruega Pais de publicación: Reino Unido