The prevalence of hyperlipidemia and features of lipid-lowering therapy in patients with myocardial infarction according to the Russian register of acute myocardial infarction REGION-MI

Aim      To study the prevalence of hyperlipidemia in patients with myocardial infarction (MI) in the Russian Federation; to assess the compliance with clinical practice guidelines of the lipid-lowering therapy prescribed upon discharge from the hospital; and to determine the number of patients who...

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Veröffentlicht in:Kardiologiia 2022-07, Vol.62 (7), p.12-22
Hauptverfasser: Boytsov, S. A., Shakhnovich, R. M., Tereschenko, S. N., Erlikh, A. D., Kukava, N. G., Pevsner, D. V., Rytova, Y. K.
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container_end_page 22
container_issue 7
container_start_page 12
container_title Kardiologiia
container_volume 62
creator Boytsov, S. A.
Shakhnovich, R. M.
Tereschenko, S. N.
Erlikh, A. D.
Kukava, N. G.
Pevsner, D. V.
Rytova, Y. K.
description Aim      To study the prevalence of hyperlipidemia in patients with myocardial infarction (MI) in the Russian Federation; to assess the compliance with clinical practice guidelines of the lipid-lowering therapy prescribed upon discharge from the hospital; and to determine the number of patients who are indicated for the combination lipid-lowering therapy to achieve the low-density lipoprotein cholesterol (LDL-C) goal. Material and methods  REGION-MI is Russian rEGIstry Of acute myocardial iNfarction, a multicenter, retrospective and prospective observational study. The observation period was divided into 3 stages: observation during the stay in the hospital and at 6 and 12 months after the inclusion in the registry. Plasma total cholesterol (TC) and LDL-C were measured in all patients on admission. Evaluation of the prescribed lipid-lowering therapy included the intensity of the treatment. Results The study included 3 620 patients; 62.4 of them had hyperlipidemia on admission. Mean TC on admission was 5.29 mmol/l and LDl-C level was 3.35 mmol/l. Upon discharge, 95.4% of patients after myocardial infarction continued on or were prescribed statin therapy; ezetimibe was prescribed to 1.22% of patients. Patients with an extremely high level of LDL-C >5 mmol/l accounted for 10.7% of patients with hyperlipidemia. The target level of LDL-C ≤1.4 mmol/l cannot be achieved with the statin and ezetimibe combination therapy in these patients; drugs from the group of PCSK9 inhibitors are indicated for them. Conclusion      According to the data of the Russian registry of acute myocardial infarction, REGION-MI, a high incidence of hyperlipidemia is observed in patients with acute MI. Despite multiple studies that have proven the importance of achieving a low LDL-C level and good tolerance and safety of ezetimibe and PCSK9 inhibitors, the prescription frequency of combination therapy remains unreasonably low. Results of a simulation study that was conducted in Sweden and the data of the REGION-MI registry showed that PCSK9 inhibitors as a part of the combination therapy are indicated for many patients. The combination therapy is presently the most powerful type of lipid-lowering treatment that allows, in most cases, achievement of the LDL-C goal.  
doi_str_mv 10.18087/cardio.2022.7.n2051
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A. ; Shakhnovich, R. M. ; Tereschenko, S. N. ; Erlikh, A. D. ; Kukava, N. G. ; Pevsner, D. V. ; Rytova, Y. K.</creator><creatorcontrib>Boytsov, S. A. ; Shakhnovich, R. M. ; Tereschenko, S. N. ; Erlikh, A. D. ; Kukava, N. G. ; Pevsner, D. V. ; Rytova, Y. K.</creatorcontrib><description>Aim      To study the prevalence of hyperlipidemia in patients with myocardial infarction (MI) in the Russian Federation; to assess the compliance with clinical practice guidelines of the lipid-lowering therapy prescribed upon discharge from the hospital; and to determine the number of patients who are indicated for the combination lipid-lowering therapy to achieve the low-density lipoprotein cholesterol (LDL-C) goal. Material and methods  REGION-MI is Russian rEGIstry Of acute myocardial iNfarction, a multicenter, retrospective and prospective observational study. The observation period was divided into 3 stages: observation during the stay in the hospital and at 6 and 12 months after the inclusion in the registry. Plasma total cholesterol (TC) and LDL-C were measured in all patients on admission. Evaluation of the prescribed lipid-lowering therapy included the intensity of the treatment. Results The study included 3 620 patients; 62.4 of them had hyperlipidemia on admission. Mean TC on admission was 5.29 mmol/l and LDl-C level was 3.35 mmol/l. Upon discharge, 95.4% of patients after myocardial infarction continued on or were prescribed statin therapy; ezetimibe was prescribed to 1.22% of patients. Patients with an extremely high level of LDL-C &gt;5 mmol/l accounted for 10.7% of patients with hyperlipidemia. The target level of LDL-C ≤1.4 mmol/l cannot be achieved with the statin and ezetimibe combination therapy in these patients; drugs from the group of PCSK9 inhibitors are indicated for them. Conclusion      According to the data of the Russian registry of acute myocardial infarction, REGION-MI, a high incidence of hyperlipidemia is observed in patients with acute MI. Despite multiple studies that have proven the importance of achieving a low LDL-C level and good tolerance and safety of ezetimibe and PCSK9 inhibitors, the prescription frequency of combination therapy remains unreasonably low. Results of a simulation study that was conducted in Sweden and the data of the REGION-MI registry showed that PCSK9 inhibitors as a part of the combination therapy are indicated for many patients. The combination therapy is presently the most powerful type of lipid-lowering treatment that allows, in most cases, achievement of the LDL-C goal.  </description><identifier>ISSN: 0022-9040</identifier><identifier>EISSN: 2412-5660</identifier><identifier>DOI: 10.18087/cardio.2022.7.n2051</identifier><language>eng ; rus</language><ispartof>Kardiologiia, 2022-07, Vol.62 (7), p.12-22</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c260t-291621fc8555abd46b15eae919b36618d2f224d11e147186e46a9175b358ba743</citedby><cites>FETCH-LOGICAL-c260t-291621fc8555abd46b15eae919b36618d2f224d11e147186e46a9175b358ba743</cites><orcidid>0000-0002-0967-0962 ; 0000-0002-5290-0065 ; 0000-0003-0607-2673 ; 0000-0003-3248-0224 ; 0000-0001-9234-6129 ; 0000-0001-5550-6090 ; 0000-0001-6998-8406</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids></links><search><creatorcontrib>Boytsov, S. A.</creatorcontrib><creatorcontrib>Shakhnovich, R. M.</creatorcontrib><creatorcontrib>Tereschenko, S. N.</creatorcontrib><creatorcontrib>Erlikh, A. D.</creatorcontrib><creatorcontrib>Kukava, N. G.</creatorcontrib><creatorcontrib>Pevsner, D. V.</creatorcontrib><creatorcontrib>Rytova, Y. K.</creatorcontrib><title>The prevalence of hyperlipidemia and features of lipid-lowering therapy in patients with myocardial infarction according to the Russian register of acute myocardial infarction REGION-MI</title><title>Kardiologiia</title><description>Aim      To study the prevalence of hyperlipidemia in patients with myocardial infarction (MI) in the Russian Federation; to assess the compliance with clinical practice guidelines of the lipid-lowering therapy prescribed upon discharge from the hospital; and to determine the number of patients who are indicated for the combination lipid-lowering therapy to achieve the low-density lipoprotein cholesterol (LDL-C) goal. Material and methods  REGION-MI is Russian rEGIstry Of acute myocardial iNfarction, a multicenter, retrospective and prospective observational study. The observation period was divided into 3 stages: observation during the stay in the hospital and at 6 and 12 months after the inclusion in the registry. Plasma total cholesterol (TC) and LDL-C were measured in all patients on admission. Evaluation of the prescribed lipid-lowering therapy included the intensity of the treatment. Results The study included 3 620 patients; 62.4 of them had hyperlipidemia on admission. Mean TC on admission was 5.29 mmol/l and LDl-C level was 3.35 mmol/l. Upon discharge, 95.4% of patients after myocardial infarction continued on or were prescribed statin therapy; ezetimibe was prescribed to 1.22% of patients. Patients with an extremely high level of LDL-C &gt;5 mmol/l accounted for 10.7% of patients with hyperlipidemia. The target level of LDL-C ≤1.4 mmol/l cannot be achieved with the statin and ezetimibe combination therapy in these patients; drugs from the group of PCSK9 inhibitors are indicated for them. Conclusion      According to the data of the Russian registry of acute myocardial infarction, REGION-MI, a high incidence of hyperlipidemia is observed in patients with acute MI. Despite multiple studies that have proven the importance of achieving a low LDL-C level and good tolerance and safety of ezetimibe and PCSK9 inhibitors, the prescription frequency of combination therapy remains unreasonably low. Results of a simulation study that was conducted in Sweden and the data of the REGION-MI registry showed that PCSK9 inhibitors as a part of the combination therapy are indicated for many patients. The combination therapy is presently the most powerful type of lipid-lowering treatment that allows, in most cases, achievement of the LDL-C goal.  </description><issn>0022-9040</issn><issn>2412-5660</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp1kUFP4zAQha0VK20F_IM9-MglxXZsJzkixEKlAhKCszVxJtRSamdtZ1F_2v47kpYrp5Hme-_NSI-Q35ytec3q6tpC7FxYCybEulp7wRT_QVZCclEordkZWbEZFQ2T7Be5TMm1jGlVlVKpFfn_ukM6RvwHA3qLNPR0dxgxDm50He4dUPAd7RHyFDEt-EiKIXxgdP6d5h1GGA_UeTpCduhzoh8u7-j-EI6fwTCzHqLNLngK1oZ5uRjD4qUv0_wReBrx3aWMcTkBdsr4TcDL3f3m-al43FyQnz0MCS-_5jl5-3P3evtQbJ_vN7c328IKzXIhGq4F722tlIK2k7rlCgEb3rSl1rzuRC-E7DhHLitea5QaGl6ptlR1C5Usz8nVKXeM4e-EKZu9SxaHATyGKRlRMSUZV6qepfIktTGkFLE3Y3R7iAfDmTmWZU5lmaUsU5ljWeUngNGNmQ</recordid><startdate>20220731</startdate><enddate>20220731</enddate><creator>Boytsov, S. A.</creator><creator>Shakhnovich, R. M.</creator><creator>Tereschenko, S. N.</creator><creator>Erlikh, A. 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K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c260t-291621fc8555abd46b15eae919b36618d2f224d11e147186e46a9175b358ba743</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng ; rus</language><creationdate>2022</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Boytsov, S. A.</creatorcontrib><creatorcontrib>Shakhnovich, R. M.</creatorcontrib><creatorcontrib>Tereschenko, S. N.</creatorcontrib><creatorcontrib>Erlikh, A. D.</creatorcontrib><creatorcontrib>Kukava, N. G.</creatorcontrib><creatorcontrib>Pevsner, D. V.</creatorcontrib><creatorcontrib>Rytova, Y. K.</creatorcontrib><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Kardiologiia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Boytsov, S. A.</au><au>Shakhnovich, R. M.</au><au>Tereschenko, S. N.</au><au>Erlikh, A. D.</au><au>Kukava, N. G.</au><au>Pevsner, D. V.</au><au>Rytova, Y. K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The prevalence of hyperlipidemia and features of lipid-lowering therapy in patients with myocardial infarction according to the Russian register of acute myocardial infarction REGION-MI</atitle><jtitle>Kardiologiia</jtitle><date>2022-07-31</date><risdate>2022</risdate><volume>62</volume><issue>7</issue><spage>12</spage><epage>22</epage><pages>12-22</pages><issn>0022-9040</issn><eissn>2412-5660</eissn><abstract>Aim      To study the prevalence of hyperlipidemia in patients with myocardial infarction (MI) in the Russian Federation; to assess the compliance with clinical practice guidelines of the lipid-lowering therapy prescribed upon discharge from the hospital; and to determine the number of patients who are indicated for the combination lipid-lowering therapy to achieve the low-density lipoprotein cholesterol (LDL-C) goal. Material and methods  REGION-MI is Russian rEGIstry Of acute myocardial iNfarction, a multicenter, retrospective and prospective observational study. The observation period was divided into 3 stages: observation during the stay in the hospital and at 6 and 12 months after the inclusion in the registry. Plasma total cholesterol (TC) and LDL-C were measured in all patients on admission. Evaluation of the prescribed lipid-lowering therapy included the intensity of the treatment. Results The study included 3 620 patients; 62.4 of them had hyperlipidemia on admission. Mean TC on admission was 5.29 mmol/l and LDl-C level was 3.35 mmol/l. Upon discharge, 95.4% of patients after myocardial infarction continued on or were prescribed statin therapy; ezetimibe was prescribed to 1.22% of patients. Patients with an extremely high level of LDL-C &gt;5 mmol/l accounted for 10.7% of patients with hyperlipidemia. The target level of LDL-C ≤1.4 mmol/l cannot be achieved with the statin and ezetimibe combination therapy in these patients; drugs from the group of PCSK9 inhibitors are indicated for them. Conclusion      According to the data of the Russian registry of acute myocardial infarction, REGION-MI, a high incidence of hyperlipidemia is observed in patients with acute MI. Despite multiple studies that have proven the importance of achieving a low LDL-C level and good tolerance and safety of ezetimibe and PCSK9 inhibitors, the prescription frequency of combination therapy remains unreasonably low. Results of a simulation study that was conducted in Sweden and the data of the REGION-MI registry showed that PCSK9 inhibitors as a part of the combination therapy are indicated for many patients. 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title The prevalence of hyperlipidemia and features of lipid-lowering therapy in patients with myocardial infarction according to the Russian register of acute myocardial infarction REGION-MI
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