| Summary: | BACKGROUND: According to National Cholesterol Education Program Adult
Treatment Panel III (NCEP ATP III) update 2004, patients with myocardial
infarction has been classified as very high-risk patient. The panel then
recommends an optional LDL-C goal <70 mg/dL for this patients. This study
evaluated the extent to which this recommendation can be attained by the use of
currently available statin therapies.
METHODS: The study was a descriptive analytical observational study
conducted a retrospective study through medical records and laboratory data of
myocardial infarction patients aged � 18 years who received statin therapies and
monitored within 6 month since patients diagnosed with acute myocardial
infarction to undergo outpatients at cardiac clinic General Hospital Center of Dr.
Sardjito Yogyakarta between 1 January 2009 and 30 September 2013.
Descriptive statistics are used to determine the general characteristics of the
patients and the profile of statin therapy. Non-parametric analysis was done to
determine whether statin therapy within 6 months can attain a significant
reduction in LDL-C level and bivariate analysis to determine factors associated
with LDL-C goal attainment.
RESULTS and CONCLUSION: A total of 141 patients diagnosed with acute
myocardial infarction (AMI) were included in this study. Most of the patients
were male (82.3%), aged between 55-64 years (36.9%), had a BMI <25 kg/m2
(66.7%), smoking (42.6%) had comorbid � 3 (58.2%) with the most comorbid is
dyslipidemia (75.9%), and getting co-medication � 6 (68.1%) with antiplatelet as
the most co-medication (100%). The most statin widely prescribed was
simvastatin (50.4%). Most patients experienced much change in their treatment
regimen (62.4%) with average changes in treatment regimens per patient was 1.5
± 0.8 times (1-5 times). The most changes in treatment regimen was atorvastatin
40 mg/day to simvastatin 10 mg/day (18.4%). Regimen for patients who their
treatment remain constant (unchanged) within six months was simvastatin 20
mg/day (23.4%) followed by atorvastatin 40 mg/day (7.1%). Overall, statin
therapy within 6 months after patients diagnosed with AMI, produces a
significant reduction in LDL-C levels by 19.5% (p<0.0001) with median final
LDL-C level was 103 (39-276) mg/dL (means: 109.24±37.18 mg/dL), while
median initial LDL-C level was 128 (48-293) mg/dL (means: 132.22±40.61
mg/dL). However, this reduction did not occur in all patients, only 109 patients
(77.3%) experienced reduction in their LDL-C levels while 32 patients (22.7%)
experienced an increase in their LDL-C levels. Patients who can attain LDL-C
goal <70 mg/dL only 18 patients (12.7%) and factors associated with attainment
of this LDL-C goal is patient adherence in taking statin drug consistently.
Keywords: myocardial infarction, statin, LDL-C, LDL-C
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