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Missed Opportunities in Implementation and Optimization of Lipid-Lowering Therapies in Very-High-Risk Patients Presenting with ST-Segment Elevation Myocardial Infarction.
Kopp, Kristen; Motloch, Lukas; Berezin, Alexander; Maringgele, Victoria; Ostapenko, Halyna; Mirna, Moritz; Schmutzler, Lukas; Dieplinger, Anna; Hoppe, Uta C; Lichtenauer, Michael.
Afiliación
  • Kopp K; Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University, 5020 Salzburg, Austria.
  • Motloch L; Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University, 5020 Salzburg, Austria.
  • Berezin A; Department of Internal Medicine II, Salzkammergut Klinikum, 4840 Vöcklabruck, Austria.
  • Maringgele V; Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University, 5020 Salzburg, Austria.
  • Ostapenko H; Internal Medicine Department, State Medical University of Zaporozhye, 69061 Zaporozhye, Ukraine.
  • Mirna M; Department of Psychiatry, Psychotherapy and Psychosomatics, Paracelsus Medical University, 5020 Salzburg, Austria.
  • Schmutzler L; Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University, 5020 Salzburg, Austria.
  • Dieplinger A; Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University, 5020 Salzburg, Austria.
  • Hoppe UC; Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University, 5020 Salzburg, Austria.
  • Lichtenauer M; Institute for Nursing and Practice, Paracelsus Medical University, 5020 Salzburg, Austria.
J Clin Med ; 12(17)2023 Aug 31.
Article en En | MEDLINE | ID: mdl-37685752
The aim of this retrospective study was to provide real-world data on lipid-lowering therapy (LLT) implementation and low-density lipoprotein cholesterol (LDL-C) target achievement in an ST-segment elevation myocardial infarction (STEMI) population, with a focus on very-high-risk patients according to European guidelines criteria. METHODS: Included were all STEMI patients with available LDL-C and total cholesterol treated at a large tertiary center in Salzburg, Austria, 2018-2020 (n = 910), with stratification into very-high-risk cohorts. Analysis was descriptive, with variables reported as number, percentages, median, and interquartile range. RESULTS: Among patients with prior LLT use, statin monotherapy predominated, 5.3% were using high-intensity statins, 1.2% were using combined ezetimibe therapy, and none were taking PCSK9 inhibitors at the time of STEMI. In very-high-risk secondary prevention cohorts, LLT optimization was alarmingly low: 8-22% of patients were taking high-intensity statins, just 0-6% combined with ezetimibe. Depending on the very-high-risk cohort, 27-45% of secondary prevention patients and 58-73% of primary prevention patients were not taking any LLTs, although 19-60% were actively taking/prescribed medications for hypertension and/or diabetes mellitus. Corresponding LDL-C target achievement in all very-high-risk cohorts was poor: <22% of patients had LDL-C values < 55 mg/dL at the time of STEMI. CONCLUSION: Severe shortcomings in LLT implementation and optimization, and LDL-C target achievement, were observed in the total STEMI population and across all very-high-risk cohorts, attributable in part to deficits in care delivery.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Etiology_studies / Guideline / Observational_studies / Risk_factors_studies Idioma: En Revista: J Clin Med Año: 2023 Tipo del documento: Article País de afiliación: Austria Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Etiology_studies / Guideline / Observational_studies / Risk_factors_studies Idioma: En Revista: J Clin Med Año: 2023 Tipo del documento: Article País de afiliación: Austria Pais de publicación: Suiza