The achievement of optimal low density lipoprotein level by patients with stable ischemic heart disease: A study in Ibn Al-Bitar cardiac center

Abstract

Background: Intensive lipid-lowering therapy plays a crucial role in the secondary prevention of patients with acute coronary syndrome and stable ischemic heart disease. Guidelines recommend achieving a low-density lipoprotein cholesterol (LDL-C) level below 70 mg/dL as the primary treatment goal. Objectives: This study aimed to assess the frequency of LDL-C target value attainment and its predictors among patients with stable ischemic heart disease attending Ibn Al-Bitar Center for Cardiac Surgery. Methods: A cross-sectional study was conducted from February 15th to August 15th, 2020, on a convenient sample of 300 patients with stable ischemic heart disease. Patients’ demographic, clinical, and behavioral data were collected through interviews, along with medical record reviews. All participants had undergone a recent lipid analysis (within 30 days) and had been on statin therapy for at least 3 months. Results: Among the 300 patients studied, 96.7% were receiving statin treatment, with 71.4% on high-intensity therapy. The mean LDL-C level was 68.13±25.007 mg/dL, with a mean atorvastatin-equivalent dose of 42.41±20.267 mg. Older age, male gender, absence of hypertension, stroke, and peripheral arterial disease, along with high-intensity statin therapy, were significantly associated with better LDL-C target attainment. Obese patients were less likely to reach the LDL-C target (67.2% vs. 30.2%). Conclusion: The LDL-C target of <70 mg/dL was achieved by 66.3% of the patients. Significant predictors of reaching this target included older age, male gender, and absence of hypertension and stroke.