Related Experiment Video
Updated: May 28, 2025
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Statin Use and Major Adverse Cardiovascular Events Among Patients with Ischemic Heart Diseases: A Multi-Center
Awatif Hafiz1, Sarah Aljohani2, Hussam Kutbi1
1Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah 22252, Saudi Arabia.
Insights
Adhering to 2018 ACC/AHA dyslipidemia guidelines for ischemic heart disease (IHD) patients improves lipid management and reduces major adverse cardiovascular events (MACEs). However, overall lipid management in IHD patients requires further improvement.
Area of Science:
- Cardiology
- Clinical Practice Guidelines
- Dyslipidemia Management
Background:
- Ischemic heart disease (IHD) necessitates effective lipid-lowering therapy.
- The 2018 ACC/AHA dyslipidemia guidelines provide a framework for managing lipid disorders.
- Assessing guideline adherence is crucial for optimizing patient outcomes in IHD.
Purpose of the Study:
- To evaluate the impact of adherence to the 2018 ACC/AHA dyslipidemia guidelines on lipid-lowering therapy in IHD patients.
- To examine the correlation between guideline adherence and major adverse cardiovascular events (MACEs).
- To assess the achievement of LDL-C goals in relation to guideline adherence.
Main Methods:
- A multi-center retrospective observational study involving 1011 IHD patients over two years (2019-2020).
- Assessment of adherence to 2018 ACC/AHA guidelines and statin utilization.
- Statistical analyses (chi-square, Mann-Whitney) to correlate adherence with MACE rates and LDL-C goal achievement.
Main Results:
- Adherent patients had significantly lower baseline LDL-C, higher statin use (78.4% vs. 57.4%), and better LDL-C goal achievement (49.2% vs. 30.5%).
- Guideline adherence was associated with reduced rates of non-fatal myocardial infarction (9.3% vs. 21.1%) and revascularization (9.3% vs. 16.8%).
- No significant differences were observed in stroke, peripheral arterial disease, or mortality rates between adherent and non-adherent groups.
Conclusions:
- Adherence to the 2018 ACC/AHA dyslipidemia guidelines is linked to improved LDL-C goal attainment and fewer MACEs in IHD patients.
- Despite positive associations, current lipid management in IHD patients remains suboptimal.
- There is a need for enhanced strategies to improve guideline adherence and lipid management in this population.
Abstract:
Objective: The objective of this study was to evaluate the effects of adherence to the ACC/AHA 2018 dyslipidemia guidelines on patient management of lipid-lowering therapy in patients with ischemic heart diseases (IHD) and its correlation with major adverse cardiovascular events (MACEs), including non-fatal MI, stroke, death, hospitalization for revascularization, and peripheral arterial disease. Methods: A multi-center retrospective observational study was conducted in patients with IHD between January 2019 and December 2020, who were followed for two years. The primary objective was to assess statin utilization and adherence to the 2018 ACC/AHA guidelines and the associated influence on MACE outcomes. Inferential statistical analyses, including chi-square tests and the Mann-Whitney test, were conducted to assess the associations between adherence to the guidelines, MACE rates, and LDL-C goal achievement. Results: The study included 1011 patients with ischemic heart disease (IHD), predominantly male (78.2%), with a mean age of 59 ± 10.9 years. Non-adherent patients had higher baseline LDL-C levels (3.0 ± 1.1 mmol/L vs. 2.7 ± 1.2 mmol/L; p = 0.0005), while adherent patients were more likely to be on cardiovascular medications, including statins (78.4% vs. 57.4%), aspirin (74.2% vs. 56.3%), and P2Y12 inhibitors (69.5% vs. 48.4%), compared to non-adherent patients. Adherence was associated with lower non-fatal MI rates (9.3% vs. 21.1%, p < 0.0001) and fewer revascularizations (9.3% vs. 16.8%; p = 0.0024). Additionally, 49.2% of adherent patients achieved target LDL-C goals, compared to 30.5% of the non-adherent patients (p < 0.0001). Notably, there were no significant differences in stroke, peripheral arterial disease, or mortality rates. Conclusions: The achievement of target LDL-C goals and reduced MACEs was observed with adherence to the 2018 ACC/AHA dyslipidemia guidelines. However, lipid management in IHD patients remains sub-optimal, highlighting opportunities for further enhancement.
More Related Videos
09:15Differential Effects of Lipid-lowering Drugs in Modulating Morphology of Cholesterol Particles
Published on: November 10, 2017
05:41Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control
Published on: December 16, 2022
Related Concept Videos
01:20Lipid-Lowering Drugs: Statins and Miscellaneous Agents
01:25Antianginal Drugs: Calcium Channel Blockers and Ranolazine
CCBs, a diverse class that includes dihydropyridines (nifedipine) and diphenylalkylamines (verapamil and diltiazem), exert their effect by blocking calcium channels in cardiac and smooth muscle cells. This...
01:22Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
01:22Heart Failure Drugs: β-Blockers
01:20Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...