Shehab Abdulla, Bhagavathula Akshaya Srikanth
Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
Heart Views. 2020 Apr-Jun;21(2):80-87. doi: 10.4103/HEARTVIEWS.HEARTVIEWS_115_19. Epub 2020 Jun 29.
Attaining guideline-recommended low-density lipoprotein cholesterol (LDL-C) goals (<70 mg/dl or ≥ 50% reduction) with statin therapy remains suboptimal after an acute coronary syndrome (ACS). This study aimed to assess the level of lipid-lowering therapy (LLT) utilization and achievement of LDL-C targets after ACS hospitalization in the United Arab Emirates (UAE).
A retrospective, observational, longitudinal database analysis of Emirati patients with ACS or stable coronary heart disease was evaluated from January 2015 to June 2018. Patients were divided based on whether or not they were treated with LLT at index hospitalization with ACS. LDL-C target level achievement was assessed according to the 2013 American College of Cardiology/American Heart Association and European Society of Cardiology/European Atherosclerosis Society guidelines.
A total of 3,066 patients (mean age 65.5 ± 14 years) met the inclusion criteria. Overall, 58.1% ( = 1782) of the patients in the cohort were on LLT during the ACS hospitalization. At discharge, the mean LDL-C level was 84.8 ± 39.0 mg/dl, and 28%, 21%, and 9% received high-, moderate-, and low-intensity statins, respectively. At 6 months ( = 2046; 66.7%), 27.7% and 16.7% achieved an LDL-C of <70 mg/dl and 70-100 mg/dl, respectively. The highest level of LDL-C reduction by 50% within 6 months was observed among patients using moderate-intensity statin (37.2%).
A large proportion of Emirati patients were not on LLT after ACS, and the rate of LDL-C target value attainment was extremely poor (27.7%). Optimal statin utilization by closely implementing the guidelines in the UAE is recommended.
急性冠状动脉综合征（ACS）后，使用他汀类药物治疗达到指南推荐的低密度脂蛋白胆固醇（LDL-C）目标（<70mg/dl或降低≥50%）的情况仍不理想。本研究旨在评估阿拉伯联合酋长国（阿联酋）ACS住院后降脂治疗（LLT）的使用水平以及LDL-C目标的达成情况。
对2015年1月至2018年6月期间患有ACS或稳定型冠心病的阿联酋患者进行回顾性、观察性纵向数据库分析。根据患者在ACS首次住院时是否接受LLT治疗进行分组。根据2013年美国心脏病学会/美国心脏协会以及欧洲心脏病学会/欧洲动脉粥样硬化学会的指南评估LDL-C目标水平的达成情况。
共有3066例患者（平均年龄65.5±14岁）符合纳入标准。总体而言，队列中的58.1%（n = 1782）患者在ACS住院期间接受了LLT治疗。出院时，平均LDL-C水平为84.8±39.0mg/dl，分别有28%、21%和9%的患者接受了高强度、中等强度和低强度他汀类药物治疗。在6个月时（n = 2046；66.7%），分别有27.7%和16.7%的患者LDL-C达到<70mg/dl和70 - 100mg/dl。在使用中等强度他汀类药物的患者中，观察到6个月内LDL-C降低50%的比例最高（37.2%）。
很大一部分阿联酋患者在ACS后未接受LLT治疗，LDL-C目标值的达成率极低（27.7%）。建议在阿联酋通过严格执行指南来优化他汀类药物的使用。
