Underlying Factors Associated With Failure to Achieve Therapeutic Lipid Goals by Intensive Statin Therapy in Post-myocardial Infarction Patients

Abstract

Background and Aim: Treatment of hyperlipidemia, as a significant risk factor of cardiovascular disease with a leading role in atherosclerosis and adverse cardiovascular effects, is now a medical dilemma worldwide. Despite the comprehensive knowledge about the impact of this factor on the cardiovascular system, the achievement of therapeutic goals of medical therapy remains an unattained desire. This study aims to evaluate the underlying causes apart from the medication itself. Materials and Methods: This cross-sectional study was conducted for 6 months from March 2016. During which, 50 patients were thoroughly evaluated and followed up. The inclusion criteria were patients with acute myocardial infarction who were newly diagnosed when the first total dose of statin (atorvastatin 80 mg) was started. The exclusion criteria were a history of taking fat-reducing drugs before the study. Predetermined data extraction forms, including medical and laboratory variables and the multidimensional scale of perceived social support questionnaire (MSPSS), were completed for all patients at the first visit and after 6 months. The obtained data were analyzed using SPSS software. Results: Among 50 studied patients, 28 were men (56%), and 22 were women (44%) (P˃0.05), with Mean±SD age of 60±10.19 years. Only 20 patients (40%) could achieve the therapeutic goal of low-density lipoprotein cholesterol (˃70 mg/dL). Irregular drug consumption was the only factor that significantly differed between patients who achieved the goals and those who could not (P=0.034). Subgroup analysis among patients with regular and irregular drug consumption demonstrates that low educational levels and poor socioeconomic support significantly differed between these patients (P˃0.05). Conclusion: Some conditions independently influence the efficacy of a medical treatment to improve hyperlipidemia, including educational and socioeconomic determinants. These factors are independent of the medication. Therefore, patient’s lifestyle and their condition have to be considered in planning medical therapy.