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Objective: Lifelong statin treatment is recommended in patients with cardiovascular diseases, but drug adherence is a significant problem. The aim of this study was to investigate factors related to statin discontinuation in high-risk patients with coronary artery disease (CAD) diagnosed by coronary angiography. Methods: A total of 300 consecutive patients who were followed-up with a diagnosis of CAD were recruited. Patients were categorized as statin adherent or statin non-adherent (patients interrupting statin therapy >30 days). Study participants completed a questionnaire regarding demographic characteristics, medical history, knowledge of statin treatment, and factors related to statin discontinuation. Results: In all, 160 patients (53.3%) were found to be statin adherent. Of those, 122 patients had suffered myocardial infarction, and atorvastatin was the most prescribed statin on discharge. Among the study population, 26% were illiterate and 55% had graduated from primary school. Only 39 cases (13%) cases had a low-density lipoprotein-cholesterol level

Objectives: Previous studies have shown the association between various hematological parameters and cardiovascular diseases, and their prognostic value. In this study, we compared red cell distribution width (RDW), neutrophil lymphocyte ratio (NLR) and mean platelet volume (MPV) measurements among patients with poor coronary collateral circulation (CCC) and well-developed CCC. Study design: 326 patients with stable coronary artery disease (CAD) were evaluated retrospectively. CCC was graded by using the Rentrop classification. The poor CCC group included patients with Rentrop 0-1 CCC, and the good CCC group included Rentrop 2-3 CCC. Results: There were 171 subjects (84% male; mean age 56.6+-10.4 years) in the poor CCC group, and 155 subjects (89% male; mean age 57.6+-9.7 years) in the good CCC group. The total number of vessels with >95% stenosis (1.1+-0.5 vs. 1.0+-0.4; p=0.64) and Gensini scores (84.4+-38.8 vs. 83.3+-37.4; p=0.83) was not higher in the poor CCC group compared to the good CCC group. RDW was significantly higher in the poor CCC group compared to the good CCC group (14.19+-1.36% vs. 13.89+-1.19%; p=0.04). In multivariate logistic regression analysis, elevated levels of RDW and LDL were found to be independent predictors of poor CCC (OR 1.73, 95% CI: 1.30-2.29, p=0.01 and OR 1.01 95% CI 1.002-1.02; p=0.02, respectively). Conclusion: In the present study, poor CCC was found to be independently correlated with RDW, but not with any other hematological parameters in patients with stable CAD.

Background: High-intensity statin (HIS) therapy is widely recommended for secondary prevention after an acute myocardial infarction (AMI). The 2019 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) dyslipidemia guidelines have lowered the target low-density lipoprotein cholesterol (LDL-C) level, which necessitates a more frequent use of nonstatin therapies. Objectives: The objectives of the study were to investigate the rate of LDL-C target attainment for secondary prevention in AMI patients. Methods: This retrospective investigation included 1360 patients diagnosed with AMI in a tertiary heart center. Lipid parameters were collected within 24 h of admission and within 1 year after discharge. The medications used were retrieved from medical records, and the lowest LDL-C levels after statin treatment were used to assess the effectiveness of the therapy. LDL-C target attainment was defined according to the 2016 ESC/EAS dyslipidemia guidelines as an LDL-C level of < 70 mg/dL and a ≥ 50% reduction from baseline. In addition, the rate of LDL-C target attainment according to the 2019 ESC/EAS guidelines was defined as an LDL-C level of < 55 mg/dL and a ≥ 50% reduction from baseline. Results: In total, 502 (36.9%) and 247 (18.2%) patients reached the LDL-C targets according to the 2016 and 2019 ESC/EAS guidelines, respectively. The admission LDL-C levels were significantly lower and HIS treatment was used more frequently in patients who subsequently attained the LDL-C goal. Remarkably, 461 (34%) patients failed to reach the LDL-C goals despite HIS treatment. Only 27 (1.9%) patients were prescribed ezetimibe. Conclusion: The rate of LDL-C goal attainment in AMI patients was low, which indicates the need for combination statin and non-statin lipid-lowering therapies.