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

Jarrah, Mohamad; Ababneh, Muhannad J.; Tawalbeh, Loai Issa; Hammoudeh, Ayman; Barukba, Hanan M.; Othman, Ahmad Faidzal

doi:10.1016/j.amsu.2020.12.036

Cited by 6 publications

(5 citation statements)

References 30 publications

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“…Consistent with our findings, previous studies have reported similar associations. Numerous clinical trials have consistently revealed that female patients diagnosed with AMI tend to be of advanced age and exhibit higher prevalence of diabetes mellitus, hypertension, and other associated complications [ 22 – 26 ]. These findings are of significant importance, as they elucidate a constellation of factors that contribute to the increased susceptibility of this population to DM.…”

Section: Discussionmentioning

confidence: 99%

Statin Eligibility according to 2013 ACC/AHA and USPSTF Guidelines among Jordanian Patients with Acute Myocardial Infarction: The Impact of Gender

Ibdah

Alrawashdeh

Rawashdeh

et al. 2023

Cardiovascular Therapeutics

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The objectives of this study were to evaluate statin eligibility among Middle Eastern patients admitted with acute myocardial infarction (AMI) who had no prior use of statin therapy, according to 2013 ACC/AHA and 2016 USPSTF guidelines, and to compare statin eligibility between men and women. This was a retrospective multicenter observational study of all adult patients admitted to five tertiary care centers in Jordan with a first-time AMI, no prior cardiovascular disease, and no prior statin use between April 2018 and June 2019. Ten-year atherosclerotic cardiovascular disease (ASCVD) risk score was estimated based on ACC/AHA risk score. A total of 774 patients met the inclusion criteria. The mean age was 55 years ( SD ± 11.3 ), 120 (15.5%) were women, and 688 (88.9%) had at least one risk factor of cardiovascular disease. Compared to men, women were more likely to be older; had a history of diabetes, hypertension, and hypercholesterolemia; and had higher body mass index, systolic blood pressure, total cholesterol, and high-density lipoproteins. Compared to women, men were more likely to have a higher 10-year ASCVD risk score (14.0% vs. 17.8%, p = 0.005 ), and more men had a 10-year ASCVD risk score of ≥7.5% and ≥10%. The proportion of patients eligible for statin therapy was 80.2% based on the 2013 ACC/AHA guidelines and 59.5% based on the USPSTF guidelines. A higher proportion of men were eligible for statin therapy compared to women, based on both the 2013 ACC/AHA (81.4% vs. 73.5%, p = 0.050 ) and USPSTF guidelines (62.0% vs. 45.2%, p = 0.001 ). Among Middle Easterners, over half of patients with AMI would have been eligible for statin therapy prior to admission based on the 2013 ACC/AHA and USPSTF guidelines, with the presence of gender gap. Adopting these guidelines in clinical practice might positively impact primary cardiovascular preventive strategies in this region.

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Section: Discussionmentioning

confidence: 99%

Statin Eligibility according to 2013 ACC/AHA and USPSTF Guidelines among Jordanian Patients with Acute Myocardial Infarction: The Impact of Gender

Ibdah

Alrawashdeh

Rawashdeh

et al. 2023

Cardiovascular Therapeutics

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“…The biggest turning point in the growth of statin use was in 2013 when the American College of Cardiology (ACC) and the American Heart Association (AHA) revised the existing guidelines for preventing the risk of CVDs and their complications expanding the population of patients eligible for statin therapy [ 29 ]. Therefore, according to the new ACC/AHA recommendations, statin prescription is recommended not only to those patients who have a high risk of cardiovascular events but also to those without a history of CVDs [ 30 ]. Moreover, the use of statins was further boosted due to their cholesterol-independent (pleiotropic) effects, which may include improvement of endothelial dysfunction, antioxidant properties, inhibition of inflammatory responses, and stabilization of atherosclerotic plaques [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Dysfunctional endocannabinoid CB1 receptor expression and signaling contribute to skeletal muscle cell toxicity induced by simvastatin

Kalkan,

Panza,

Pagano

et al. 2023

Cell Death Dis

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Statins are the most prescribed lipid-lowering agents worldwide. Their use is generally safe, although muscular toxicity occurs in about 1 in 10.000 patients. In this study, we explored the role of the endocannabinoid system (ECS) during muscle toxicity induced by simvastatin. In murine C2C12 myoblasts exposed to simvastatin, levels of the endocannabinoids AEA and 2-AG as well the expression of specific miRNAs (in particular miR-152) targeting the endocannabinoid CB1 gene were increased in a time-dependent manner. Rimonabant, a selective CB1 antagonist, exacerbated simvastatin-induced toxicity in myoblasts, while only a weak opposite effect was observed with ACEA and GAT211, selective orthosteric and allosteric agonists of CB1 receptor, respectively. In antagomiR152-transfected myoblasts, simvastatin toxicity was in part prevented together with the functional rescue of CB1. Further analyses revealed that simvastatin in C2C12 cells also suppresses PKC and ERK signaling pathways, which are instead activated downstream of CB1 receptor stimulation, thus adding more insight into the mechanism causing CB1 functional inactivation. Importantly, simvastatin induced similar alterations in skeletal muscles of C57BL/6 J mice and primary human myoblasts. In sum, we identified the dysregulated expression of the endocannabinoid CB1 receptor as well as the impairment of its downstream signaling pathways as a novel pathological mechanism involved in statin-induced myopathy.

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“…The biggest turning point in the growth of statin use was in 2013 when the American College of Cardiology (ACC) and the American Heart Association (AHA) revised the existing guidelines for preventing the risk of CVDs and their complications expanding the population of patients eligible for statin therapy 26 . Therefore, according to the new ACC/AHA recommendations, statin prescription is recommended not only to those patients who have a high risk of cardiovascular events but also to those without a history of CVDs 27 . Moreover, the use of statins has been further broadened due to their cholesterol-independent (pleiotropic) effects, which may include improvement of endothelial dysfunction, antioxidant properties, inhibition of in ammatory responses, and stabilization of atherosclerotic plaques 28 .…”

Section: Discussionmentioning

confidence: 99%

MicroRNA-mediated repression of endocannabinoid CB1 receptor expression contributes to simvastatin-induced skeletal muscle toxicity

Kalkan

Panza

Pagano³

et al. 2022

Preprint

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Statins are the most prescribed lipid-lowering agents worldwide. Their use is generally safe, although muscular toxicity occurs in 1 in 10.000 patients. In this study, we explored the role of the endocannabinoid system (ECS) during muscle toxicity induced by simvastatin. In murine C2C12 myoblasts exposed to simvastatin (30 µM), we found that the levels of the endocannabinoids 2-AG and AEA as well the expression of specific miRNAs (mostly miR-152) targeting the endocannabinoid CB1 gene were increased. Rimonabant, a selective CB1 antagonist, exacerbated simvastatin-induced toxicity in myoblasts, while the opposite effect was observed with GAT211, a CB1-positive allosteric modulator. In antagomiR-152-transfected myoblasts, simvastatin toxicity was prevented along with the rescue of CB1 expression. Notably, similar alterations were found in skeletal muscles of C57BL/6J mice treated with simvastatin 20 mg Kg-1 and in primary human myoblasts. In sum, we identified the ECS as a novel mechanism participating in statin-induced myopathy.

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

Cited by 6 publications

References 30 publications

Statin Eligibility according to 2013 ACC/AHA and USPSTF Guidelines among Jordanian Patients with Acute Myocardial Infarction: The Impact of Gender

Statin Eligibility according to 2013 ACC/AHA and USPSTF Guidelines among Jordanian Patients with Acute Myocardial Infarction: The Impact of Gender

Dysfunctional endocannabinoid CB1 receptor expression and signaling contribute to skeletal muscle cell toxicity induced by simvastatin

MicroRNA-mediated repression of endocannabinoid CB1 receptor expression contributes to simvastatin-induced skeletal muscle toxicity

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