当前位置： SCI文献检索 > Journal of the American Heart Association期刊下所有文献 > Statin Eligibility and Outpatient Care Prior to ST-Segment Elevation Myocardial Infarction.

Statin Eligibility and Outpatient Care Prior to ST-Segment Elevation Myocardial Infarction.

Abstract：

BACKGROUND:The impact of the 2013 American College of Cardiology/American Heart Association cholesterol guidelines on statin eligibility in individuals otherwise destined to experience cardiovascular disease (CVD) events is unclear. METHODS AND RESULTS:We analyzed a prospective cohort of consecutive ST-segment elevation myocardial infarction (STEMI) patients from a regional STEMI system with data on patient demographics, low-density lipoprotein cholesterol levels, CVD risk factors, medication use, and outpatient visits over the 2 years prior to STEMI. We determined pre-STEMI eligibility according to American College of Cardiology/American Heart Association guidelines and the prior Third Report of the Adult Treatment Panel guidelines. Our sample included 1062 patients with a mean age of 63.7 (13.0) years (72.5% male), and 761 (71.7%) did not have known CVD prior to STEMI. Only 62.5% and 19.3% of individuals with and without prior CVD were taking a statin before STEMI, respectively. In individuals not taking a statin, median (interquartile range) low-density lipoprotein cholesterol levels in those with and without known CVD were low (108 [83, 138] mg/dL and 110 [87, 133] mg/dL). For individuals not taking a statin, only 38.7% were statin eligible by ATP III guidelines. Conversely, 79.0% would have been statin eligible according to American College of Cardiology/American Heart Association guidelines. Less than half of individuals with (49.2%) and without (41.1%) prior CVD had seen a primary care provider during the 2 years prior to STEMI. CONCLUSIONS:In a large cohort of STEMI patients, application of American College of Cardiology/American Heart Association guidelines more than doubled pre-STEMI statin eligibility compared with Third Report of the Adult Treatment Panel guidelines. However, access to and utilization of health care, a necessity for guideline implementation, was suboptimal prior to STEMI.

journal_name

J Am Heart Assoc

journal_title

Journal of the American Heart Association

authors

Miedema MD,Garberich RF,Schnaidt LJ,Peterson E,Strauss C,Sharkey S,Knickelbine T,Newell MC,Henry TD

doi

10.1161/JAHA.116.005333

subject

Has Abstract

pub_date

2017-04-12 00:00:00

issue

issn

2047-9980

pii

JAHA.116.005333

journal_volume

pub_type

杂志文章

在线工具

Statin Eligibility and Outpatient Care Prior to ST-Segment Elevation Myocardial Infarction.