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Factors associated with low-density lipoprotein control in outpatients with myocardial infarction: A hospital-based
Anan S Jarab1, Walid Al-Qerem2, Razan Mansour1
1Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan.
Insights
Most myocardial infarction (MI) patients have uncontrolled low-density lipoprotein cholesterol (LDL-C). Smoking, beta-blocker use, and uncontrolled blood pressure predict poor LDL-C control, necessitating targeted management strategies for better cardiac outcomes.
Area of Science:
- Cardiology
- Public Health
- Pharmacology
Background:
- Suboptimal low-density lipoprotein cholesterol (LDL-C) control is a significant concern in myocardial infarction (MI) patient management.
- Identifying factors influencing LDL-C control is vital for developing effective interventions to improve cardiovascular outcomes.
Purpose of the Study:
- To assess LDL-C control status in MI patients.
- To identify predictors of uncontrolled LDL-C in this population.
Main Methods:
- Retrospective data collection from medical records of MI patients in an outpatient cardiology clinic.
- Utilized validated Arabic scales for medication adherence and beliefs.
- Employed binary logistic regression to determine predictors of LDL-C control.
Main Results:
- A high prevalence of uncontrolled LDL-C was observed in 76.6% of the 255 patients studied.
- Independent predictors of uncontrolled LDL-C included current smoking (OR=2.006), beta-blocker prescription (OR=2.211), and uncontrolled blood pressure (OR=1.940).
Conclusions:
- Effective management strategies are crucial for improving LDL-C control in MI patients to reduce cardiac complications.
- Interventions should focus on smoking cessation and optimizing blood pressure control to enhance patient health outcomes.
Abstract:
Discrepancies in factors influencing low-density lipoprotein cholesterol (LDL-C) control in patients with myocardial infarction have been documented in existing literature. Assessing LDL-C control and the associated factors is a crucial initial measure for guiding future interventions aimed at enhancing health outcomes in patients with myocardial infarction (MI). This study aimed to evaluate LDL-C control status and explore the predictors of uncontrolled LDL-C in patients with myocardial infarction. Data were collected by a research pharmacist from medical records, including sociodemographic and clinical characteristics, comorbidities, prescribed medications, and biomedical parameters such as LDL-C levels among patients attending an outpatient cardiology clinic. The validated Arabic versions of the 4-item medication adherence scale and the medication beliefs questionnaire were used to evaluate medication adherence and beliefs, respectively. Binary logistic regression was implemented to investigate the predictors of LDL-C control. The results showed most of the patients (n = 255) had uncontrolled LDL-C (76.6%). Regression results revealed that smoking (OR= 2.006; 95% CI: 1.054-3.816; P = 0.034), receiving beta blockers (OR=2.211; 95% CI: 1.024-4.775; P = 0.043), and having uncontrolled blood pressure (OR=1.940; 95% CI: 1.069-3.520; P = 0.029) were independently associated with higher odds of uncontrolled LDL-C. In conclusion, in MI patients with poor LDL-C control, lowering the risk of cardiac complications and improving health outcomes require the development of focused and efficient LDL-C level management strategies. Achieving this goal will require putting strategies like smoking cessation counselling into practice and improving BP control.
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