Prevalence of lipid abnormalities and cholesterol target value attainment in patients with stable and acute coronary heart disease in the United Arab Emirates
Wael Al Mahmeed1, Sherif Bakir2, Salem A Beshyah2, Bassem Morcos3, Sameh Wajih3, Martin Horack4, Dominik Lautsch5, Baishali Ambegaonkar5, Philippe Brudi5, Carl A Baxter6, Ami Vyas7, Anselm K Gitt8
1 Cleveland Clinic, Heart and Vascular Institute; Department of Cardiology, Sheikh Khalifa Medical City, Abu Dhabi, Dubai, UAE
2 Department of Cardiology, Sheikh Khalifa Medical City, Abu Dhabi, UAE
3 Merck Sharp and Dohme, Dubai, UAE
4 Foundation Institute for Myocardial Infarction Research, Ludwigshafen, Germany
5 Merck and Co., Inc., Kenilworth, NJ, USA
6 MSD Ltd., Hoddesdon, UK
7 Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, Kingston, RI, USA
8 Foundation Institute for Myocardial Infarction Research; Medical Department B, Hospital Ludwigshafen, Ludwigshafen, Germany
Dr. Wael Al Mahmeed
Cleveland Clinic Abu Dhabi, Heart and Vascular Institute, Abu Dhabi
Source of Support: None, Conflict of Interest: None
Background: Careful management of lipid abnormalities in patients with coronary heart disease (CHD) or an acute coronary syndrome (ACS) can reduce the risk of recurrent cardiovascular events. The extent of hyperlipidemia in these very high-risk patients in the United Arab Emirates (UAE), along with the treatment strategies employed, is not clear.
Methods: The Dyslipidemia International Study II was a multinational observational analysis carried out from 2012 to 2014. Patients were enrolled if they had either stable CHD or an ACS. Patient characteristics, lipid levels, and use of lipid-lowering therapy (LLT) were recorded at enrollment. For the ACS patients, the LLT used during the 4 months' follow-up period was documented, as were any cardiovascular events.
Results: A total of 416 patients were recruited from two centers in the UAE, 216 with stable CHD and 200 hospitalized with an ACS. Comorbidities and cardiovascular risk factors were extremely common. A low-density lipoprotein cholesterol level of <70 mg/dl, recommended for patients at very high cardiovascular risk, was attained by 39.3% of the LLT-treated CHD patients and 33.3% of the LLT-treated ACS patients at enrollment. The mean atorvastatin-equivalent daily statin dose was 29 ± 15 mg for the CHD patients, with 13.7% additionally using ezetimibe. For the ACS patients, the daily dosage was 23 ± 13 mg at admission, rising to 39 ± 12 mg by the end of the 4-month follow-up. The use of nonstatin agents was extremely low in this group.
Conclusions: Despite LLT being widely used, hyperlipidemia was found to be prevalent in ACS and CHD patients in the UAE. Treatment strategies need to be significantly improved to reduce the rate of cardiovascular events in these very high-risk patients.