Evaluation of Statin Effect on Low-Density Lipoprotein Cholesterol Goal Attainment In Patients With Myocardial Infarction

Abstract

According to NCEP ATP III update 2004, patients with myocardial infarction have been classified as very high-risk patient. The panel then recommends an optional LDL-C goal 70 mg/dL for this patients. This study evaluated the extent to which this recommendation can be attained by the use of currently available statin therapies. The study was a descriptive analytical observational study conducted retrospectively through medical records and laboratory data of myocardial infarction patients aged ≥18 years who received statin therapies. The patients were monitored within 6 month since diagnosed with acute myocardial infarction at cardiac clinic of a hospital in Yogyakarta Indonesia between 1 January 2009 and 30 September 2013. Statistical analysis was done to determine whether statin therapy within 6 months can attain a significant reduction in LDL-C level and bivariate analysis to determine some factors associated with LDL-C goal attainment. A total of 141 patients diagnosed with acute myocardial infarction were included in this study. The statin prescribed was mostly simvastatin (50.4%). Most patients experienced much change in their treatment regimen (62.4%) with an average change in the treatment regimens per patient was 1.5 ± 0.8 times. The most change in treatment regimen was atorvastatin 40 mg/day to simvastatin 10 mg/day (18.4%). Regimen for patients who their treatment remain unchanged within six months was simvastatin 20 mg/day (23.4%) followed by atorvastatin 40 mg/day (7.1%). Overall, statin therapy within 6 months after the patients diagnosed with AMI, exhibited significant reduction in LDL-C levels by 19.5% (p 0.0001) with final LDL-C level was 109.24±37.18 mg/dL, while initial LDL-C level was 132.22±40.61 mg/dL. However, the reduction did not occur in all patients, only 109 patients (77.3%) experienced reduction in their LDL-C levels while 32 patients (22.7%) experienced an increase in their LDL-C levels. Only 18 patients (12.7%) can attain LDL-C goal 70 mg/dL and a factor associated with the attainment adherence in taking statin drug consistently.