Statin eligibility based on the ACC/AHA guidelines among Middle Eastern patients with diabetes mellitus presenting with acute myocardial infarction. (January 2021)

• Record Type: Journal Article
• Authors: Jarrah, Mohamad I.; Ababneh, Muhannad J.; Tawalbeh, Loai Issa; Hammoudeh, Ayman J.; Barukba, Hanan M.; Othman, Ahmad
• Is Part Of: Annals of medicine and surgery. Volume 61(2021)
• Page Start: 148
• Page End: 154
• Publication Date: 2021-01
• Subjects: ACC/AHA -- Diabetes mellitus -- Statin eligibility -- Middle east; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2020.12.036
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Background: Statin eligibility based on the American College of Cardiology/American Heart Association cholesterol guidelines among patients with diabetes admitted with first time acute myocardial infarction has not been evaluated in the Middle East. Purpose: To assess statin eligibility for diabetic patients admitted with first time myocardial infarction in Jordan according to ACC/AHA guidelines. Methods: Consecutive patients admitted with a first acute myocardial infarction who were not taking statins, and had their serum lipoproteins measured upon hospital admission were enrolled in the study. Statin eligibility among patients with diabetes admitted with first time myocardial infarction was determined based on the ACC/AHA guidelines. Results: Of 774 patients enrolled, 292 (37.30%) had diabetes. Compared with non-diabetic patients, those with diabetes were females, older, more hypertension, more hypercholesterolemia, more triglycerides, more diastolic blood pressure, less smokers and less low density lipoprotein. Among patients with diabetes, 242 diabetic patients (82.9%) were statin eligible, including 20 (6.90%) for having high serum levels of low density lipoprotein cholesterol (LDL-C) >190 mg/dL, and 222 (76%) for being aged 40–75 years with LDL-C 70–189 mg/dL. No patient had a calculated atherosclerotic cardiovascular risk score ≥7.5%. On the other hand, 393 non-diabetic patients (81.3%) were statin eligible, including 41 (8.50%) for having high serum levels of low density lipoprotein cholesterol (LDL-C) >190 mg/dL, and 351 (72.80%) for being aged 40–75 years with LDL-C 70–189 mg/dL. Conclusions: Based on the ACC/AHA guidelines, the majority of patients with diabetes admitted with first acute myocardial infarction would have been eligible for statin treatment if they have LDL-c >190 mg/dl or aged 40–75 years old and they have their LDL 70–189 mg/gl. More efforts should be taken for patients who are female, older than 50 years, hypertensive, elevated diastolic blood pressure have hypercholesterolemia, and elevated triglycerides because of their significant association with diabetes. Highlights: 83% of patients with diabetes mellitus presenting with MI, were statin eligible. 393 non-diabetic patients (81.3%) were statin eligible in the current sample. No diabetic or non-diabetic patients has a 10 year ASCVR score between 5 and 7.4 Statin was eligible in the same proportion among diabetic and diabetic patients.