Kiroga Naki, Khan Zahid
Department of Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, TZA.
Department of Cardiology, University of South Wales, Pontypridd, GBR.
Cureus. 2025 Apr 29;17(4):e83200. doi: 10.7759/cureus.83200. eCollection 2025 Apr.
Dyslipidemia remains a significant risk factor for atherosclerosis and the development of acute coronary syndrome (ACS). Consistent data have demonstrated challenging lipid control according to the European Society of Cardiology (ESC) guideline-directed target low-density lipoprotein cholesterol (LDL-C) level. The exact prevalence of dyslipidemia in Tanzania remains unclear, although it is known to be quite high, and higher in urban than in rural areas. This study aimed to evaluate the current practice of lipid assessment in patients admitted with ACS and compliance with national and international guidelines.
This retrospective hospital-based cohort study aimed to determine the current practice of dyslipidemia screening in patients with ACS admitted to the Jakaya Kikwete Cardiac Institute (JKCI) and evaluate their adherence to national and international recommended guidelines, such as ESC and American Heart Association guidelines. All patients admitted to the JKCI from June 2023 to June 2024, aged 18 years or older, and presenting with ACS, were included in this study. Data were collected using a prestructured tool created with Google Forms (Google, Mountain View, CA). Data extraction was performed in MS Excel (Microsoft Corporation, Redmond, WA) and then transferred to R software (R Foundation for Statistical Computing, Vienna, Austria) for analysis. This information is summarized in tables, graphs, and frequencies.
This study included 124 patients diagnosed with ACS admitted to the JKCI center. Of this cohort, 58 (47%) patients had their LDL-C levels checked within 48 hours of presentation. The follow-up of lipids after admission was documented in 10% of the patients. Only 9.5% achieved the guideline-recommended LDL-C goal. Most patients were initiated on and maintained on a high-intensity statin, with no data on the use of nonstatin therapy.
The findings of this study have mirrored many irregularities in the current practice of dyslipidemia screening among patients with ACS admitted to JKCI. This study also highlighted the local nonadherence to national and international recommended guidelines, which, in turn, undermines secondary prevention of cardiovascular events. Further larger multicentered studies are recommended to assess the scope of the problem to reduce the burden and risk of future events.
血脂异常仍然是动脉粥样硬化和急性冠状动脉综合征（ACS）发生的重要危险因素。一致的数据表明，根据欧洲心脏病学会（ESC）指南指导的目标低密度脂蛋白胆固醇（LDL-C）水平，血脂控制具有挑战性。坦桑尼亚血脂异常的确切患病率尚不清楚，尽管已知其相当高，且城市地区高于农村地区。本研究旨在评估ACS住院患者血脂评估的当前做法以及对国家和国际指南的遵循情况。
这项基于医院的回顾性队列研究旨在确定在贾卡亚·基奎特心脏研究所（JKCI）住院的ACS患者血脂异常筛查的当前做法，并评估他们对国家和国际推荐指南的遵循情况，如ESC和美国心脏协会指南。2023年6月至2024年6月期间入住JKCI、年龄在18岁及以上且患有ACS的所有患者均纳入本研究。数据使用谷歌表单（谷歌，加利福尼亚州山景城）创建的预结构化工具收集。数据提取在MS Excel（微软公司，华盛顿州雷德蒙德）中进行，然后转移到R软件（R统计计算基金会，奥地利维也纳）进行分析。这些信息以表格、图表和频率的形式进行总结。
本研究纳入了124名在JKCI中心被诊断为ACS的患者。在这个队列中，58名（47%）患者在就诊后48小时内检查了LDL-C水平。10%的患者记录了入院后血脂的随访情况。只有9.5%的患者达到了指南推荐的LDL-C目标。大多数患者开始并维持使用高强度他汀类药物，没有关于非他汀类药物治疗使用情况的数据。
本研究的结果反映了JKCI住院的ACS患者当前血脂异常筛查实践中的许多不规范之处。本研究还强调了当地对国家和国际推荐指南的不遵循，这反过来又削弱了心血管事件的二级预防。建议进一步开展更大规模的多中心研究，以评估问题的范围，减轻未来事件的负担和风险。
