Affiliation:
1. Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan
2. Division of Cardiology, Departments of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan
3. Institute of Biomedical Sciences, Mackay Medical College, New Taipei City 25245, Taiwan
Abstract
Background: Dyslipidemia is a known risk factor for cardiac dysfunction, and lipid-lowering therapy with statins reduces symptoms and reduces hospitalization related to left ventricular heart failure. Acute myocardial infarction (AMI) is a cause of morbidity and mortality worldwide. In this study, we aimed to determine the real-world AMI treatment drug combination used in Taiwan by using the NHI database to understand the treatment outcomes of current clinical medications prescribed for hyperlipidemia patients with AMI. Methods: Using the NHI Research Database (NHIRD), we conducted a retrospective cohort study that compared different treatments for AMI in hyperlipidemia patients in the period from 2016 to 2018. We compared the survival outcomes between those treated with and without organic nitrates in this cohort. Results: We determined that most hyperlipidemia patients were aged 61–70 y (29.95–31.46% from 2016 to 2018), and the annual AMI risk in these patients was <1% (0.42–0.68% from 2016 to 2018). The majority of hyperlipidemia patients with AMI were women, and 25.64% were aged 61–70 y. Receiving organic nitrates was associated with lower all-cause mortality rates (HR, 95% CI, p-value = 0.714, 0.674–0.756, p < 0.0001). After multivariate analysis, the overall survival in four groups (beta-blockers, beta-blocker + diuretics, diuretics, and others) receiving an organic nitrate treatment was significantly higher than in the groups that were not treated with organic nitrates (beta-blockers HR = 0.536, beta-blocker + diuretics HR = 0.620, diuretics HR = 0.715, and others HR = 0.690). Conclusions: The survival benefit was significantly greater in patients treated with organic nitrates than in those treated without organic nitrates, especially when combined with diuretics. A combination of organic nitrates could be a better treatment option for hyperlipidemia patients with AMI.
Reference27 articles.
1. Diet and health trends in Taiwan: Comparison of two nutrition and health surveys from 1993–1996 and 2005–2008;Pan;Asia Pac. J. Clin. Nutr.,2011
2. Plasma lipid profiles and epidemiology of atherosclerotic diseases in Taiwan—A unique experience;Pan;Atherosclerosis,1995
3. Epidemiology of myocardial infarction in Korea: Hospitalization incidence, prevalence, and mortality;Kim;Epidemiol. Health,2022
4. Incidence, Relevant Patient Factors, and Clinical Outcomes of the Misdiagnosis of ST-Segment-Elevation Myocardial Infarction: Results From the Korea Acute Myocardial Infarction Registry;Cho;J. Am. Heart Assoc.,2023
5. Statescu, C., Anghel, L., Tudurachi, B.S., Leonte, A., Benchea, L.C., and Sascau, R.A. (2022). From Classic to Modern Prognostic Biomarkers in Patients with Acute Myocardial Infarction. Int. J. Mol. Sci., 23.