Limits...
Secular trends in lipid-lowering treatment and lipid levels after a first acute myocardial infarction.

Björck L, Welin C, Rosengren A - Vasc Health Risk Manag (2007)

Bottom Line: The beneficial effects of statins were unequivocally demonstrated in the Scandinavian Simvastatin Survival Study (4S) in 1994, leading to an increase in the use of lipid-lowering drugs.Descriptive single centre study using consecutive data collection in 781 patients (aged <65 years) hospitalized with a first AMI during the period 1994-2002.From 1994-2002, the use of lipid-lowering drugs increased from 10% to 94% for men and from 23% to 90% for women.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Sahlgrenska University Hospital/Ostra, Göteborg, Sweden. lena.m.bjorck@vgregion.se

ABSTRACT

Background: The beneficial effects of statins were unequivocally demonstrated in the Scandinavian Simvastatin Survival Study (4S) in 1994, leading to an increase in the use of lipid-lowering drugs. However, to what extent this translates into serum cholesterol levels in a real-life setting has not been systematically investigated.

Objective: To estimate secular trends from 1994 to 2002 in blood lipid levels among unselected younger patients after a first acute myocardial infarction (AMI).

Method: Descriptive single centre study using consecutive data collection in 781 patients (aged <65 years) hospitalized with a first AMI during the period 1994-2002.

Results: From 1994-2002, the use of lipid-lowering drugs increased from 10% to 94% for men and from 23% to 90% for women. In 1994, the mean serum cholesterol levels were 6.53 mmol/l in men and 6.32 mmol/l in women, decreasing to 4.31 mmol/l and 5.13 mmol/l in men and women, respectively, in 2002. Still, only 56% of the men and 35% of the women had total serum cholesterol levels <4.5 mmol/l in 2002.

Conclusion: Despite a marked increase in lipid-lowering drug treatment in which there was an increase from about 10% in 1994 to more than 90% in 2002, current target levels of <4.5 mmol/l for serum cholesterol were not achieved in a significant proportion of post-AMI patients.

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Related in: MedlinePlus

Mean serum triglycerides in men and women at 3-months follow-up after hospitalization for first myocardial infarction during 1994–2002.
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fig3: Mean serum triglycerides in men and women at 3-months follow-up after hospitalization for first myocardial infarction during 1994–2002.

Mentions: The proportion treated with lipid-lowering drugs increased substantially during the investigated period in both genders (Figure 1). In 1994, 10% of all men and 23% of all women were treated with lipid-lowering drugs. In 2002, the proportion of patients treated with lipid-lowering drugs had increased to approximately 90% in both men and women. The linear trend over the period was significant in both men and women (p < 0.0001). In 1994, the mean total serum cholesterol was 6.53 (SD 1.27) and 6.32 mmol/l (SD 1.34) in men and women, respectively. During the study period, the mean serum cholesterol levels decreased steadily and, in 2002, the mean serum cholesterol in men and women, respectively, was 4.31 (SD 1.16) and 5.13 mmol/l (SD 1.47) (Figure 2). The linear trend was significant for both genders (p < 0.0001). Mean serum triglycerides also decreased during the years 1994 to 2002. In 1994, the mean serum triglyceride levels were 2.55 mmol/l (SD 1.58) in men and 2.16 mmol/l (SD 1.11) in women, and in 2002 1.72 mmol/l (SD 0.81) and 1.77 mmol/l (SD 1.13) in men and women, respectively (Figure 3) (p for linear trend over time was <0.0001 in men and <0.05 in women). In 2002, 65% of the men and 50% of the women had total serum cholesterol levels <5.0 mmol/l. If target levels for serum total cholesterol instead were defined as <4.5 mmmol/l), these levels were achieved in 56% of the cases in men and 35% in women.


Secular trends in lipid-lowering treatment and lipid levels after a first acute myocardial infarction.

Björck L, Welin C, Rosengren A - Vasc Health Risk Manag (2007)

Mean serum triglycerides in men and women at 3-months follow-up after hospitalization for first myocardial infarction during 1994–2002.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2350148&req=5

fig3: Mean serum triglycerides in men and women at 3-months follow-up after hospitalization for first myocardial infarction during 1994–2002.
Mentions: The proportion treated with lipid-lowering drugs increased substantially during the investigated period in both genders (Figure 1). In 1994, 10% of all men and 23% of all women were treated with lipid-lowering drugs. In 2002, the proportion of patients treated with lipid-lowering drugs had increased to approximately 90% in both men and women. The linear trend over the period was significant in both men and women (p < 0.0001). In 1994, the mean total serum cholesterol was 6.53 (SD 1.27) and 6.32 mmol/l (SD 1.34) in men and women, respectively. During the study period, the mean serum cholesterol levels decreased steadily and, in 2002, the mean serum cholesterol in men and women, respectively, was 4.31 (SD 1.16) and 5.13 mmol/l (SD 1.47) (Figure 2). The linear trend was significant for both genders (p < 0.0001). Mean serum triglycerides also decreased during the years 1994 to 2002. In 1994, the mean serum triglyceride levels were 2.55 mmol/l (SD 1.58) in men and 2.16 mmol/l (SD 1.11) in women, and in 2002 1.72 mmol/l (SD 0.81) and 1.77 mmol/l (SD 1.13) in men and women, respectively (Figure 3) (p for linear trend over time was <0.0001 in men and <0.05 in women). In 2002, 65% of the men and 50% of the women had total serum cholesterol levels <5.0 mmol/l. If target levels for serum total cholesterol instead were defined as <4.5 mmmol/l), these levels were achieved in 56% of the cases in men and 35% in women.

Bottom Line: The beneficial effects of statins were unequivocally demonstrated in the Scandinavian Simvastatin Survival Study (4S) in 1994, leading to an increase in the use of lipid-lowering drugs.Descriptive single centre study using consecutive data collection in 781 patients (aged <65 years) hospitalized with a first AMI during the period 1994-2002.From 1994-2002, the use of lipid-lowering drugs increased from 10% to 94% for men and from 23% to 90% for women.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Sahlgrenska University Hospital/Ostra, Göteborg, Sweden. lena.m.bjorck@vgregion.se

ABSTRACT

Background: The beneficial effects of statins were unequivocally demonstrated in the Scandinavian Simvastatin Survival Study (4S) in 1994, leading to an increase in the use of lipid-lowering drugs. However, to what extent this translates into serum cholesterol levels in a real-life setting has not been systematically investigated.

Objective: To estimate secular trends from 1994 to 2002 in blood lipid levels among unselected younger patients after a first acute myocardial infarction (AMI).

Method: Descriptive single centre study using consecutive data collection in 781 patients (aged <65 years) hospitalized with a first AMI during the period 1994-2002.

Results: From 1994-2002, the use of lipid-lowering drugs increased from 10% to 94% for men and from 23% to 90% for women. In 1994, the mean serum cholesterol levels were 6.53 mmol/l in men and 6.32 mmol/l in women, decreasing to 4.31 mmol/l and 5.13 mmol/l in men and women, respectively, in 2002. Still, only 56% of the men and 35% of the women had total serum cholesterol levels <4.5 mmol/l in 2002.

Conclusion: Despite a marked increase in lipid-lowering drug treatment in which there was an increase from about 10% in 1994 to more than 90% in 2002, current target levels of <4.5 mmol/l for serum cholesterol were not achieved in a significant proportion of post-AMI patients.

Show MeSH
Related in: MedlinePlus