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Evaluation of two highly effective lipid-lowering therapies in subjects with acute myocardial infarction.

ABSTRACT: For cardiovascular disease prevention, statins alone or combined with ezetimibe have been recommended to achieve low-density lipoprotein cholesterol targets, but their effects on other lipids are less reported. This study was designed to examine lipid changes in subjects with ST-segment elevation myocardial infarction (STEMI) after two highly effective lipid-lowering therapies. Twenty patients with STEMI were randomized to be treated with rosuvastatin 20 mg QD or simvastatin 40 mg combined with ezetimibe 10 mg QD for 30 days. Fasting blood samples were collected on the first day (D1) and after 30 days (D30). Lipidomic analysis was performed using the Lipidyzer platform. Similar classic lipid profile was obtained in both groups of lipid-lowering therapies. However, differences with the lipidomic analysis were observed between D30 and D1 for most of the analyzed classes. Differences were noted with lipid-lowering therapies for lipids such as FA, LPC, PC, PE, CE, Cer, and SM, notably in patients treated with rosuvastatin. Correlation studies between classic lipid profiles and lipidomic results showed different information. These findings seem relevant, due to the involvement of these lipid classes in crucial mechanisms of atherosclerosis, and may account for residual cardiovascular risk.Randomized clinical trial: ClinicalTrials.gov, NCT02428374, registered on 28/09/2014.

SUBMITTER: Klassen A

PROVIDER: S-EPMC8342504 | biostudies-literature | 2021 Aug

REPOSITORIES: biostudies-literature

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Evaluation of two highly effective lipid-lowering therapies in subjects with acute myocardial infarction.

Klassen Aline A Faccio Andrea Tedesco AT Picossi Carolina Raissa Costa CRC Derogis Priscilla Bento Matos Cruz PBMC Dos Santos Ferreira Carlos Eduardo CE Lopes Aline Soriano AS Sussulini Alessandra A Cruz Elisa Castañeda Santa ECS Bastos Rafaela Tudela RT Fontoura Stefanie Caroline SC Neto Antonio Martins Figueiredo AMF Tavares Marina Franco Maggi MFM Izar Maria Cristina MC Fonseca Francisco Antonio Helfenstein FAH

Scientific reports 20210805 1

For cardiovascular disease prevention, statins alone or combined with ezetimibe have been recommended to achieve low-density lipoprotein cholesterol targets, but their effects on other lipids are less reported. This study was designed to examine lipid changes in subjects with ST-segment elevation myocardial infarction (STEMI) after two highly effective lipid-lowering therapies. Twenty patients with STEMI were randomized to be treated with rosuvastatin 20 mg QD or simvastatin 40 mg combined with ...[more]

PMID: 34354179

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Project description:ObjectivesThis study aimed to measure adherence to chronic polytherapy following an acute myocardial infarction (AMI) and to find out associations between adherence and the setting of AMI onset (in vs out of hospital) as well as other determinants.DesignRetrospective follow-up study.SettingPopulation living in the Lazio Region, Italy.ParticipantsThis study included 25 779 hospitalised patients with a first diagnosis of AMI in 2012-2016, after the exclusion of those with hospital admission for AMI or related causes in the previous 5 years.Primary and secondary outcome measuresPatients were classified as in-hospital AMI (IH-AMI) or out of hospital AMI (OH-AMI) according to present-on-admission codes. Adherence was measured based on prescription claims during a 6-month follow-up after hospital discharge, using medication possession ratio (MPR). Adherence to chronic polytherapy was defined as MPR ≥75% to at least 3 of the following medications: antithrombotics, betablockers, ACE inhibitors/angiotensin receptor blockers and statins.ResultsAmong the entire cohort, 1 044 (4%) patients suffered IH-AMI. Overall, 15 440 (60%) patients were deemed adherent to chronic polytherapy. Female gender, older age, mental disorders, renal disease, asthma and ongoing concomitant treatments were factors associated with poor adherence. By contrast, patients with more severe AMI and those already taking evidence-based (E-B) drugs were more likely to be adherent. A strong association between the setting of AMI onset and adherence was observed: IH-AMI patients were 46% less likely to be adherent to E-B medications during their 6-month follow-up as compared with OH-AMI patients (OR 0.54; 95% CI 0.47 to 0.62; p<0.001).ConclusionPharmacotherapy is not consistent with clinical guidelines, especially for IH-AMI patients. Our findings provide evidence on a previously unidentified groups of patients at risk for poor adherence, who might benefit from greater medical attention and dedicated healthcare interventions.

Dataset Information

Evaluation of two highly effective lipid-lowering therapies in subjects with acute myocardial infarction.

Publications

Evaluation of two highly effective lipid-lowering therapies in subjects with acute myocardial infarction.

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