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The prevalence of hyperlipidemia and features of lipid-lowering therapy in patients with myocardial infarction according to the Russian register of acute myocardial infarction REGION-MI.
- Source :
-
Kardiologiia [Kardiologiia] 2022 Jul 31; Vol. 62 (7), pp. 12-22. Date of Electronic Publication: 2022 Jul 31. - Publication Year :
- 2022
-
Abstract
- Aim      To study the prevalence of hyperlipidemia in patients with myocardial infarction (MI) in the Russian Federation; to assess the compliance with clinical practice guidelines of the lipid-lowering therapy prescribed upon discharge from the hospital; and to determine the number of patients who are indicated for the combination lipid-lowering therapy to achieve the low-density lipoprotein cholesterol (LDL-C) goal.Material and methods  REGION-MI is Russian rEGIstry Of acute myocardial iNfarction, a multicenter, retrospective and prospective observational study. The observation period was divided into 3 stages: observation during the stay in the hospital and at 6 and 12 months after the inclusion in the registry. Plasma total cholesterol (TC) and LDL-C were measured in all patients on admission. Evaluation of the prescribed lipid-lowering therapy included the intensity of the treatment.Results The study included 3 620 patients; 62.4 of them had hyperlipidemia on admission. Mean TC on admission was 5.29 mmol/l and LDl-C level was 3.35 mmol/l. Upon discharge, 95.4% of patients after myocardial infarction continued on or were prescribed statin therapy; ezetimibe was prescribed to 1.22% of patients. Patients with an extremely high level of LDL-C >5 mmol/l accounted for 10.7% of patients with hyperlipidemia. The target level of LDL-C ≤1.4 mmol/l cannot be achieved with the statin and ezetimibe combination therapy in these patients; drugs from the group of PCSK9 inhibitors are indicated for them.Conclusion      According to the data of the Russian registry of acute myocardial infarction, REGION-MI, a high incidence of hyperlipidemia is observed in patients with acute MI. Despite multiple studies that have proven the importance of achieving a low LDL-C level and good tolerance and safety of ezetimibe and PCSK9 inhibitors, the prescription frequency of combination therapy remains unreasonably low. Results of a simulation study that was conducted in Sweden and the data of the REGION-MI registry showed that PCSK9 inhibitors as a part of the combination therapy are indicated for many patients. The combination therapy is presently the most powerful type of lipid-lowering treatment that allows, in most cases, achievement of the LDL-C goal.
- Subjects :
- Cholesterol, LDL
Ezetimibe therapeutic use
Humans
PCSK9 Inhibitors
Prevalence
Proprotein Convertase 9
Retrospective Studies
Russia epidemiology
Anticholesteremic Agents therapeutic use
Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use
Hyperlipidemias complications
Hyperlipidemias drug therapy
Hyperlipidemias epidemiology
Myocardial Infarction complications
Myocardial Infarction epidemiology
Subjects
Details
- Language :
- Russian; English
- ISSN :
- 0022-9040
- Volume :
- 62
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Kardiologiia
- Publication Type :
- Academic Journal
- Accession number :
- 35989625
- Full Text :
- https://doi.org/10.18087/cardio.2022.7.n2051