American College of Cardiology Conference 2020: Acute Myocardial Infarction
Medlior’s presentation focuses on a real-world evidence study sponsored by Amgen Inc. examining the management of patients with an acute myocardial infarction (AMI) in Alberta, Canada. AMI is a leader in disease burden and death worldwide. In order to combat AMI, modifiable factors that lower cholesterol, specifically low-density lipoprotein-cholesterol (LDL-C) are needed. Therapies designed to lower LDL-C, such as statins, also called lipid lowering therapies (LLT), are therefore important to understand the patterns of use and to what extent LDL-C is lowered. Medlior’s study utilized health system data to explore the patterns of LLT and the management of LDL-C levels in patients who experienced AMI.
Albertan residents over the age of 18 who experienced an AMI between April 1, 2011 to March 31, 2015 were included in the study. LLT prescription dispenses and LDL-C levels were captured before and after the AMI event.
A total of n=26,040 patients were diagnosed with an AMI within the study period. Of those, 66% were male and the average age of the study cohort was 68 years. A large proportion (79%) of patients with an AMI also had hypertension as a comorbidity.
Prior to AMI:
- 61% of patients did not receive any LLT therapy
- 64% did not meet the LDL-C level threshold, as per the Canadian guidelines (<2.0 mmol/L)
- For those who did receive LLT, most had received moderate-intensity statins
- 23% of patients did not receive any LLT therapy
- 30% were not meeting the LDL-C level thresholds
- For those who did receive LLT, most had received high-intensity statins
The results of Medlior’s study showed a significant gap in the management for patients with an AMI, where despite a diagnosis, over 20% of patients were still not on LLT after their AMI. Further, for those receiving LLT, one-third of patients were not meeting the recommended thresholds for LDL-C levels. Therefore, exploring alternative strategies to aggressively reduce LDL-C levels in patients with AMI in Alberta are warranted.
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- Scory T, Chen G, Farris MS, Shih YH, Pinto L, Cowling T. Lipid-lowering therapy patterns and low-density lipoprotein-cholesterol management among patients with acute myocardial infarction in Alberta, Canada. American College of Cardiology (ACC).20/World Congress of Cardiology (WCC) Virtual; March-June 2020; Virtual.