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Risk Factors Associated with Failure to Achieve the Low Density Lipoprotein Cholesterol Therapeutic Target in Patients with Acute Coronary Syndrome: A Longitudinal, Single Centre Investigation

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Abstract

Introduction

Reducing low-density lipoprotein cholesterol (LDL-C) to target < 100 mg/dL is considered as a critical therapeutic goal after acute coronary syndrome (ACS).

Aim

To evaluate the factors associated with reaching or not this LDL-C target after 6 months of statin therapy.

Methods

Demographic features and other clinically relevant information from a cohort of patients enrolled from April 3, 2016 through March 20, 2017 were analyzed in the current investigation. All included cases had baseline LDL-C levels ≥ 100 mg/dL. LDL-C levels were determined once again after 6-month of statin therapy for each patient.

Results

Two hundred and thirty two participants were included in the final analysis. One third of patients (33.2%) with ACS with initially elevated LDL-C failed to attain LDL-C goal at 6 months. Spearman correlation test showed that the age, diabetes mellitus, lipid lowering therapy and statin daily dose were among the influential factors associated with LDL-C goal achievement. Furthermore, multiple logistic regression analysis revealed that diabetes mellitus and statin treatment before admission were the only independent predictors of achieving LDL-C goal.

Conclusions

According to our findings, the drug adherence and use of higher intensity as recommended in secondary prevention are needed to increase the achievement of LDL-C treatment targets.

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Acknowledgements

We gratefully acknowledge all of the participants and entire staff involved at the Cardiology Ward of Seyyed-Alshohada Hospital for their help.

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Authors and Affiliations

  1. Cardiology Department, Urmia University of Medical Sciences, Urmia, 57147-83734, Iran

    Mojgan Hajahmadi Pourrafsanjani, Ebrahim Khayati Shal & Sina Khezrpour

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  1. Mojgan Hajahmadi Pourrafsanjani
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  2. Ebrahim Khayati Shal
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Correspondence to Mojgan Hajahmadi Pourrafsanjani.

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The authors declare that they have no conflict of interest.

Ethical approval

The study was conducted in accordance with the Declaration of Helsinki and was approved by the Ethics Committees of the Urmia University of Medical Sciences.

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Written informed consent was obtained from all participants prior to enrollment.

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Hajahmadi Pourrafsanjani, M., Khayati Shal, E. & Khezrpour, S. Risk Factors Associated with Failure to Achieve the Low Density Lipoprotein Cholesterol Therapeutic Target in Patients with Acute Coronary Syndrome: A Longitudinal, Single Centre Investigation. High Blood Press Cardiovasc Prev 26, 37–43 (2019). https://doi.org/10.1007/s40292-019-00298-5

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