1. Prevalence and Predictors of Out-of-Target LDL Cholesterol 1 to 3 Years After Myocardial Infarction. A Subanalysis From the EYESHOT Post-MI Registry.
- Author
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Silverio, Angelo, Benvenga, Rossella Maria, Piscione, Federico, Gulizia, Michele M., Meessen, Jennifer M. T. A., Colivicchi, Furio, Nardi, Federico, Baldi, Cesare, Galasso, Gennaro, Vecchione, Carmine, Di Lenarda, Andrea, Gabrielli, Domenico, and De Luca, Leonardo
- Subjects
LOW density lipoproteins ,MYOCARDIAL infarction ,BLOOD cholesterol ,PERCUTANEOUS coronary intervention ,CHOLESTEROL ,LOGISTIC regression analysis ,GOAL (Psychology) - Abstract
Background: There is an incomplete understanding of the prevalence and predictors of attainment of low-density lipoprotein cholesterol (LDL-C) goal after myocardial infarction (MI). Aim: To evaluate the prevalence of achievement of LDL-C goal of 70 mg/dL, to identify the baseline features associated with suboptimal lipid control, and to assess the use of LDL-C-lowering drug therapies (LLT) beyond the first year after MI. Methods: The EYESHOT Post-MI was a prospective, cross-sectional, Italian registry, which enrolled patients presenting to cardiologist 1 to 3 years after MI. In this retrospective post-hoc analysis, patients were categorized in 2 groups according to the achievement or not of the LDL-C goal of 70 mg/dL. Univariable and multivariable logistic regression analyses were performed to identify the baseline features associate with LDL-C≥70 mg/dL. Results: The study population included 903 patients (mean age 65.5 ± 11.5 years). Among them, LDL-C was ≥70 mg/dL in 474 (52.5%). Male sex (P = 0.031), hypertension (P = 0.024), prior percutaneous coronary intervention (P = 0.016) and high education level (P = 0.008) were higher in the LDL-C <70 group. At multivariable analysis, low education level was an independent predictor of LDL-C≥70 mg/dL (OR:1.582; 95%CI, 1.156-2.165; P = 0.004). Conversely, hypertension increased the probability to achieve the LDL-C goal (OR:0.650; 95%CI, 0.443-0.954; P = 0.028). Among off-target patients, LLT was not modified in the majority of cases (67.3%), intensified in 85 (18.6%), and actually reduced in 63 patients (13.8%). Conclusions: In patients presenting to cardiologists 1 to 3 years from the last MI event, LDL-C is not under control in a large proportion of patients, particularly in those with a low education level or without hypertension. LLT is underused in this very-high-risk setting. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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