Prevalence of lipid abnormalities and cholesterol target value attainment in patients with stable coronary heart disease or an acute coronary syndrome in Saudi Arabia

Sifri, Saud Al; Shammeri, Owayed Al; Jaser, Saleh Al; Alkhenizan, Abdullah; Shafiurrehman, Atif Bin Shafi; Morcos, Bassem; Wajih, Sameh; Elnahal, Ibrahim; Horack, Martin; Brudi, Phillippe; Lautsch, Dominik; Ambegaonkar, Baishali; Vyas, Ami; Baxter, Carl A.; Gitt, Anselm K.

doi:10.15537/smj.2018.7.22146

Cited by 5 publications

(8 citation statements)

References 20 publications

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“…It is well-established that ACS patients are at extremely high risk for cardiovascular incidents [10]. Also, dyslipidemia is a well-recognized risk factor for CHD progression, and this has been confirmed in many clinical studies [17].…”

Section: Discussionmentioning

confidence: 96%

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The Diagnostic Accuracy of Cardiac Enzymes-Lipid Profile Ratio for Diagnosing Coronary Heart Disease in Chest Pain Patients

Kadry¹,

Zahran²,

Emran³

et al. 2021

TOBIOCJ

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Background: Lipid abnormalities increase Coronary Heart Disease (CHD) risk. Our developed indexes 1,2 were reported in scientific Journals. Here, we verified and evaluated the cardiac enzymes-lipid profile ratio's diagnostic value for diagnosing CHD patients. Methods: Lipid profiles and cardiac enzymes were estimated in all chest pain patients. The area under the receiver-operating characteristic curve (AUC) was used to evaluate the markers' diagnostic accuracy. Results: There were varieties of significant differences (P < 0.01- P < 0.0001) of Creatine Kinase MB (CK-MB) - lipid profile ratio and Troponin I-lipid profile ratio within the groups of chest pain patients. For discriminating between Non-Coronary Chest Pain (NCCP) and Stable Angina (SA) groups, the AUCs were the greatest for CK-MB- High-density Lipoprotein (HDL) ratio (0.62) and for Troponin I-HDL (0.62). Moreover, for discriminating between NCCP and Unstable Angina (UA) groups, the AUC was the greatest for CK-MB-HDL ratio (0.97). Also, for discriminating between NCCP and Acute Myocardial Infarction (AMI) groups, the AUC was the greatest for index 2 (0.99). Similarly, for discriminating between SA and UA groups, the AUC was the greatest for CK-MB-HDL ratio (0.90). For discriminating between SA and AMI groups, the AUC was the greatest for index 2 (0.97). Finally, for discriminating between UA and AMI groups, the AUC was the greatest for index 2 (0.78). Conclusion: Independent CK-MB-HDL ratio can be used as a good and simple index for diagnosing CHD in chest pain patients and discriminating between the different groups of these patients

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Section: Discussionmentioning

confidence: 96%

“…Such risk can be diminished by good controlling of associated modifiable risk factors [9]. Lipid abnormality, for example, high concen-tration of triglycerides or Low-Density Lipoprotein (LDL) and low level of HDL, are famous for being highly widespread in ACS patients [10].…”

Section: Introductionmentioning

confidence: 99%

The Diagnostic Accuracy of Cardiac Enzymes-Lipid Profile Ratio for Diagnosing Coronary Heart Disease in Chest Pain Patients

Kadry¹,

Zahran²,

Emran³

et al. 2021

TOBIOCJ

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“…Where data were not available from the STARS-1 dataset, alternative sources were used, such as Al Sifri et al [ 21 ], a multicenter observational study investigating the prevalence of lipid abnormalities and cholesterol values in patients with stable dyslipidemia in the KSA. Baseline mean LDL-C levels were obtained from Altowaijri et al [ 22 ].…”

Section: Methodsmentioning

confidence: 99%

“…Maximally tolerated statin (with or without ezetimibe) was chosen as the background LLT on top of which evolocumab may be administered as an adjunct therapy. Background LLT statin proportions applied in the model were sourced from Alburikan et al [ 52 ], and proportions of concomitant ezetimibe were sourced from Al Sifri et al [ 21 ]. For simplicity, we assumed that low-intensity statins reported were equal to moderate-intensity statins.…”

Section: Methodsmentioning

confidence: 99%

Cost-Effectiveness Analysis of Evolocumab for the Treatment of Dyslipidemia in the Kingdom of Saudi Arabia

Alghamdi

Balkhi

Altowaijri

et al. 2021

PharmacoEconomics Open

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Background Proprotein convertase subtilisin/kexin type 9 inhibitors, such as evolocumab, are cholesterol-lowering drugs effective in lowering lipid levels in high-risk patients with primary hypercholesterolemia or mixed dyslipidemia. Objective This study assessed the cost effectiveness of evolocumab in combination with lipid-lowering therapies (LLTs) compared with LLTs alone, from a public healthcare perspective in the Kingdom of Saudi Arabia (KSA). Methods A Markov cohort state transition model was used, incorporating efficacy estimates from the FOURIER clinical trial and baseline cardiovascular event rates observed in clinical practice. Other model inputs were extracted from the literature and Saudi sources. Results In patients with clinically evident atherosclerotic cardiovascular disease and baseline low-density lipoprotein cholesterol ≥ 70 or ≥ 100 mg/dL, adding evolocumab to a maximally tolerated statin, with or without ezetimibe, was associated with incremental cost-effectiveness ratios (ICERs) of Saudi Arabian riyal (SAR) 109,274 ($US60,708) per quality-adjusted lifeyear (QALY) gained and SAR75,163 ($US41,757) per QALY gained, respectively. The ICER was SAR22,391 ($US12,440) per QALY gained in patients with heterozygous familial hypercholesterolemia. Sensitivity analysis results were robust to changes in model parameters and fell below the willingness-to-pay threshold of up to three times gross domestic product per capita in 2019 (SAR264,813 [$US147,118]). Conclusion Evolocumab can be considered a cost-effective treatment option for patients with atherosclerotic cardiovascular disease or heterozygous familial hypercholesterolemia in the KSA.

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“…[ 14 15 16 17 18 ] Previous studies showed that less than one-third (28% women vs. 32% men) of the Arabian Gulf patients with ASCVD achieved their LDL-C targets. [ 16 19 20 21 ] However, little is known regarding the therapeutic management and achievement of guideline-recommended LDL-C goals in the UAE. The present study aimed to assess the real-world evidence of lipid-lowering therapy (LLT) utilization and achievement of LDL-C targets after ACS in the region of Abu Dhabi, UAE.…”

Section: Introductionmentioning

confidence: 99%

Statin therapy and low-density lipoprotein cholesterol reduction after acute coronary syndrome: Insights from the United Arab Emirates

Shehab

Bhagavathula

2020

Heart Views

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Background and Aims: Attaining guideline-recommended low-density lipoprotein cholesterol (LDL-C) goals (<70 mg/dl or ≥ 50% reduction) with statin therapy remains suboptimal after an acute coronary syndrome (ACS). This study aimed to assess the level of lipid-lowering therapy (LLT) utilization and achievement of LDL-C targets after ACS hospitalization in the United Arab Emirates (UAE). Methods: A retrospective, observational, longitudinal database analysis of Emirati patients with ACS or stable coronary heart disease was evaluated from January 2015 to June 2018. Patients were divided based on whether or not they were treated with LLT at index hospitalization with ACS. LDL-C target level achievement was assessed according to the 2013 American College of Cardiology/American Heart Association and European Society of Cardiology/European Atherosclerosis Society guidelines. Results: A total of 3,066 patients (mean age 65.5 ± 14 years) met the inclusion criteria. Overall, 58.1% ( n = 1782) of the patients in the cohort were on LLT during the ACS hospitalization. At discharge, the mean LDL-C level was 84.8 ± 39.0 mg/dl, and 28%, 21%, and 9% received high-, moderate-, and low-intensity statins, respectively. At 6 months ( n = 2046; 66.7%), 27.7% and 16.7% achieved an LDL-C of <70 mg/dl and 70–100 mg/dl, respectively. The highest level of LDL-C reduction by 50% within 6 months was observed among patients using moderate-intensity statin (37.2%). Conclusion: A large proportion of Emirati patients were not on LLT after ACS, and the rate of LDL-C target value attainment was extremely poor (27.7%). Optimal statin utilization by closely implementing the guidelines in the UAE is recommended.

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Prevalence of lipid abnormalities and cholesterol target value attainment in patients with stable coronary heart disease or an acute coronary syndrome in Saudi Arabia

Cited by 5 publications

References 20 publications

The Diagnostic Accuracy of Cardiac Enzymes-Lipid Profile Ratio for Diagnosing Coronary Heart Disease in Chest Pain Patients

The Diagnostic Accuracy of Cardiac Enzymes-Lipid Profile Ratio for Diagnosing Coronary Heart Disease in Chest Pain Patients

Cost-Effectiveness Analysis of Evolocumab for the Treatment of Dyslipidemia in the Kingdom of Saudi Arabia

Statin therapy and low-density lipoprotein cholesterol reduction after acute coronary syndrome: Insights from the United Arab Emirates

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