Untreated Dyslipidemia in Lebanese Patients With Schizophrenia

Area of Science:

• Cardiology
• Psychiatry
• Public Health

Background:

• Schizophrenia is associated with an increased risk of atherosclerotic cardiovascular disease (ASCVD).
• Current guidelines for statin therapy differ, potentially leading to varied treatment recommendations for patients with schizophrenia.
• Dyslipidemia is common in patients with schizophrenia, necessitating effective risk assessment strategies.

Purpose of the Study:

• To determine the prevalence of statin-untreated schizophrenic patients eligible for statin therapy based on the 2013 ACC/AHA guidelines.
• To compare the performance of the 2013 ACC/AHA guidelines with the 2004 NCEP ATP-III recommendations in this patient group.
• To assess the ASCVD risk factors in schizophrenic patients requiring statin treatment.

Main Methods:

• A cross-sectional study involving 329 patients diagnosed with schizophrenia (DSM-5 criteria).
• Data collected from medical charts, patient interventions, and anthropometric measures between April and July 2016.
• Evaluation of dyslipidemia and ASCVD risk according to both ACC/AHA and NCEP ATP-III guidelines.

Main Results:

• The 2013 ACC/AHA guidelines identified 81.25% more patients needing statin therapy compared to the 2004 NCEP ATP-III guidelines.
• Only 9.1% of the total population met the criteria for both sets of guidelines concurrently.
• Among patients indicated for statin therapy by ACC/AHA guidelines, 95.4% had an ASCVD risk of ≥ 7.5%, 10% had diabetes, and 0.8% had clinical CVD.

Conclusions:

• The 2013 ACC/AHA guidelines are more sensitive than the 2004 NCEP ATP-III guidelines in identifying schizophrenic patients with dyslipidemia and high ASCVD risk.
• The absolute clinical benefit and potential risks of statin therapy based on these guidelines remain uncertain in schizophrenic patients.
• Further research is required to evaluate the actual reduction in CVD events and compare the benefits of statin assignment in this population.