Rauf R, Soomro MI, Khan MN, Kumar M, Soomro NA, Kazmi KA. Assessment of post-myocardial infarction lipid levels and management: Results from a tertiary care hospital of Pakistan. World J Cardiol 2024; 16(5): 282-292 [PMID: 38817645 DOI: 10.4330/wjc.v16.i5.282]
Corresponding Author of This Article
Rubina Rauf, FCPS, Assistant Professor, Department of Preventive Cardiology, National Institute of Cardiovascular Diseases, Rafiqui (H.J.) Shaheed Road, Karachi 75510, Pakistan. drrubinarauf@gmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. May 26, 2024; 16(5): 282-292 Published online May 26, 2024. doi: 10.4330/wjc.v16.i5.282
Assessment of post-myocardial infarction lipid levels and management: Results from a tertiary care hospital of Pakistan
Rubina Rauf, Muhammad Ismail Soomro, Muhamman Nauman Khan, Mukesh Kumar, Najia Aslam Soomro, Khawar Abbas Kazmi
Rubina Rauf, Muhammad Ismail Soomro, Khawar Abbas Kazmi, Department of Preventive Cardiology, National Institute of Cardiovascular Diseases, Karachi 75510, Pakistan
Muhamman Nauman Khan, Mukesh Kumar, Department of Adult Cardiology, National Institute of Cardiovascular Diseases, Karachi 75510, Pakistan
Najia Aslam Soomro, Department of Cardiology, Liaquat National Hospital, Karachi 74800, Pakistan
Author contributions: Rauf R, Soomro MI, Khan MN, Kumar M, Soomro NA and Kazmi KA contributed to the concept, design of the study, the collection, analysis, interpretation of data and the drafting of the manuscript; Rauf R, Soomro MI, Kumar M and Kazmi KA critically analyzed all content. All authors have read and approved the manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the National Institute of Cardiovascular Diseases (NICVD), Karachi (No. ERC-26/2022).
Informed consent statement: Written consent was waived by the institution review board due to observational nature of the study, hence, verbal informed consent was obtained from all the patients.
Conflict-of-interest statement: All authors have no conflict of interest to disclose.
Data sharing statement: Data and material will be available upon request.
STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rubina Rauf, FCPS, Assistant Professor, Department of Preventive Cardiology, National Institute of Cardiovascular Diseases, Rafiqui (H.J.) Shaheed Road, Karachi 75510, Pakistan. drrubinarauf@gmail.com
Received: December 23, 2023 Revised: April 1, 2024 Accepted: April 22, 2024 Published online: May 26, 2024 Processing time: 152 Days and 7.5 Hours
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.
Core Tip: Lipid treatment practices and levels in post-acute myocardial infarction (AMI) patients, which are crucial for secondary prevention. This study examined lipid treatment practices and levels in post-AMI patients at a Pakistani tertiary care hospital. Among 195 patients, only 13.8% underwent lipid profile testing post-AMI. While 88.7% received recommended statin therapy, only 11.5% achieved target low-density lipoprotein cholesterol levels. Non-compliance with statin therapy correlated with higher re-admission and subsequent AMI rates. The findings underscore the importance of optimizing lipid assessment practices to reduce the risk of recurrent events in post-AMI patients.
