Secular trends in lipid-lowering treatment and lipid levels after a first acute myocardial infarction

Abstract

Background

The beneficial effects of statins were unequivocally demonstrated in the Scandinavian Simvastatin Survival Study (4S) in 1994, leading to an increase in the use of lipid-lowering drugs. However, to what extent this translates into serum cholesterol levels in a real-life setting has not been systematically investigated.

Objective

To estimate secular trends from 1994 to 2002 in blood lipid levels among unselected younger patients after a first acute myocardial infarction (AMI).

Method

Descriptive single centre study using consecutive data collection in 781 patients (aged <65 years) hospitalized with a first AMI during the period 1994–2002.

Results

From 1994–2002, the use of lipid-lowering drugs increased from 10% to 94% for men and from 23% to 90% for women. In 1994, the mean serum cholesterol levels were 6.53 mmol/l in men and 6.32 mmol/l in women, decreasing to 4.31 mmol/l and 5.13 mmol/l in men and women, respectively, in 2002. Still, only 56% of the men and 35% of the women had total serum cholesterol levels <4.5 mmol/l in 2002.

Conclusion

Despite a marked increase in lipid-lowering drug treatment in which there was an increase from about 10% in 1994 to more than 90% in 2002, current target levels of <4.5 mmol/l for serum cholesterol were not achieved in a significant proportion of post-AMI patients.

Keywords:

• lipid levels
• lipid-lowering medication
• myocardial infarction
• risk factors

Acknowledgements

The study was supported by FOU-rådet in Göteborg and Södra Bohuslän, Västra Götalandsregionen and Merck, Sharp and Dohme. Conduct of the study and preparation of the manuscript were funded by an unrestricted grant from Merck, Sharp and Dohme. The company had no role in the interpretation of the data or preparation, review or approval of the manuscript. Conflicts of interest: A Rosengren has received consulting fees and lecture fees from Astrazeneca, as well as lecture fees from Pfizer, Merck, Sharp and Dohme, and Novartis but has no relevant financial interest in the manuscript.