Karimi Raheleh, Zarepur Ehsan, Khosravi Alireza, Mohammadifard Noushin, Nouhi Fereidoon, Alikhasi Hasan, Nasirian Shima, Sadeghi Masoumeh, Roohafza Hamidreza, Moezi Bady Seyed Ali, Solati Kamal, Lotfizadeh Masoud, Ghaffari Samad, Javanmardi Elmira, Gholipour Mahboobeh, Cheraghi Mostafa, Assareh Ahmadreza, Haybar Habib, Namayandeh Seyedeh Mahdieh, Kojuri Javad, Mansourian Marjan, Sarrafzadegan Nizal
Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Int J Cardiol Cardiovasc Risk Prev. 2023 Jan 14;16:200168. doi: 10.1016/j.ijcrp.2023.200168. eCollection 2023 Mar.
Statins use is the most important treatment for high LDL cholesterol in patients with premature coronary artery disease (CAD). Previous reports have shown racial and gender differences in statin use in the general population, but this wasn't studied in premature CAD based on different ethnicities.
Our study includes 1917 men and women with confirmed diagnosis of premature CAD. Logistic regression model was used to evaluate the high LDL cholesterol control in the groups and the OR with 95% confidence interval (CI) was reported as the effect size. After adjustment for confounders, the odds of controlling LDL in women taking Lovastatin, Rosuvastatin, and Simvastatin were 0.27 (0.03, 0.45) lower in comparison with men. Also, in participant who took 3 types of statins, the odds of controlling LDL were significantly different between Lor and Arab compared with Fars ethnicity. After adjustment to all confounders (full model), the odds of controlling LDL were lower for Gilak in Lovastatin, Rosuvastatin, and Simvastatin by 0.64 (0.47, 0.75); 0.61 (0.43, 0.73); 0.63 (0.46, 0.74) respectively and higher for Arab in Lovastatin, Rosuvastatin, and Simvastatin by 4.63 (18.28, 0.73); 4.67 (17.47, 0.74); 4.55 (17.03, 0.71) respectively compared to Fars.
Major differences in different gender and ethnicities may have had led to disparities in statin use and LDL control. Awareness of the statins impact on high LDL cholesterol based on different ethnicities can help health decision-makers to close the observed gaps in statin use and control LDL to prevent CAD problems.
他汀类药物的使用是早发冠心病（CAD）患者高LDL胆固醇治疗的最重要手段。既往报告显示，普通人群中他汀类药物的使用存在种族和性别差异，但基于不同种族的早发CAD患者的他汀类药物使用情况尚未得到研究。
我们的研究纳入了1917例确诊为早发CAD的男性和女性。采用逻辑回归模型评估各组的高LDL胆固醇控制情况，并报告具有95%置信区间（CI）的OR作为效应量。在对混杂因素进行调整后，服用洛伐他汀、瑞舒伐他汀和辛伐他汀的女性控制LDL的几率比男性低0.27（0.03，0.45）。此外，在服用3种他汀类药物的参与者中，洛尔族和阿拉伯族与法尔斯族相比，控制LDL的几率存在显著差异。在对所有混杂因素进行调整（完全模型）后，服用洛伐他汀、瑞舒伐他汀和辛伐他汀的吉拉克族控制LDL的几率分别低0.64（0.47，0.75）；0.61（0.43，0.73）；0.63（0.46，0.74），而阿拉伯族服用洛伐他汀、瑞舒伐他汀和辛伐他汀控制LDL的几率分别比法尔斯族高4.63（18.28，0.73）；4.67（17.47，0.74）；4.55（17.03，0.71）。
不同性别和种族之间的主要差异可能导致了他汀类药物使用和LDL控制的差异。了解基于不同种族的他汀类药物对高LDL胆固醇的影响，有助于卫生决策者缩小观察到的他汀类药物使用差距并控制LDL，以预防CAD问题。
