Underlying factors associated with failure to achieve therapeutic lipid goals by intensive statin therapy in post myocardial infarction patients

Treatment of hyperlipidemia, as a major risk factor of cardiovascular disease with the leading role in atherosclerosis and cardiovascular adverse effect, is now a medical dilemma worldwide. Notwithstanding the comprehensive knowledge about the impact of this factor on cardiovascular system, successful achievement of therapeutic goals of medical therapy still remains an unattained desire. The aim of this study is to evaluate the underlying causes apart from medication itself.

This study was performed cross-sectional. In this study, which was conducted for 6 months from March 2016, 50 patients were fully evaluated and followed up. Inclusion criteria for patients with acute myocardial infarction were newly diagnosed when the first full dose of statin (Atorvastatin 80 mg) was started for them. Exclusion criteria were 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. Data were analyzed using SPSS software.

Among 50 patients completely reviewed, 28 were men (56%) and 22 were women (44%) (P˃ 0.05), with the mean age of 60 (±10.19) years old. Only 20 patients (40%) could achieve therapeutic goal of LDL-c (˃ 70 mg/dl). Irregular drug consumption was the only factor significantly differed between patients who achieved the goals and those could not achieve (P= 0.034). Subgroup analysis among patients with regular and irregular drug consumption demonstrate that low educational level along with poor socio-economic support were significantly differed between these patients (P˃ 0.05).

There are some conditions independently influence the efficacy of a medical treatment to improve hyperlipidemia including educational and socio-economic determinants, apart from issues related to medication itself. Therefore, patient’s lifestyle and their condition have to be considered in planning a medical therapy.