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


METHODS
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.


CONCLUSIONS
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.
Björck
Lena
L
Department of Medicine, Sahlgrenska University Hospital/Ostra, Göteborg, Sweden. lena.m.bjorck@vgregion.se
Welin
Catharina
C
Rosengren
Annika
A
D002784:Cholesterol / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000517:prevention & control*; D012307:Risk Factors; D012737:Sex Factors; D013548:Sweden; D014280:Triglycerides / Q000097:blood*
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D014280:Triglycerides; D002784:Cholesterol