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André Bernardi
University Center UNIFAPI, BrazilPresentation Title:
LDL cholesterol goals after myocardial infarction: real-world data from the Brazilian Public Health System
Abstract
Background: Cardiovascular diseases (CVD) are the leading cause of death worldwide, and the burden of CVD is higher in low and middle-income countries. Reduction of LDL-C levels is the cornerstone in risk reduction, but many high-risk patients are not achieving the recommended lipid goals, even in high income countries.
Aim: To evaluate whether patients in the Brazilian public health system are reaching LDL-C goals after an acute myocardial infarction (AMI), including both the attainment to the LDL-C target levels and the percentage of LDL-C reduction.
Methods: This retrospective cohort explored the data of patients admitted with AMI between 2008 and 2015 in public hospitals in the city of Curitiba. To evaluate the attainment to LDL-C target, we used the last value registered in the database for each patient up to 2016. For those who had at least one LDL-C registered in the year before AMI, percentage of reduction was calculated.
Results: Of 7,066 patients admitted for AMI, 1,451 were followed in any out-patient setting and had at least one evaluation of LDL-C. Mean age was 60.8 ± 11.4 years and 35.8%, 35.2%, 21.5%, and 7.4% of patients had LDL-C levels >100, 70–100, 50–70, and <50 mg/dL, respectively. Of these, 377 patients also had at least one LDL-C evaluation before the AMI. The mean LDL-C concentrations were 128.1 and 93.3 mg/dL before and after AMI, with a mean reduction of 27.1% (34.8 mg/dL). LDL-C levels were reduced by more than 50% in only 18.3% of the cases.
Conclusion: As in the rest of the world, the majority of high risk patients followed in the Brazilian public health system are not achieving adequate LDL-C levels after AMI.
Biography
Andre Bernardi is a Brazilian cardiologist and Fellow of the European Society of Cardiology (FESC). He earned his specialist title from the Brazilian Society of Cardiology and holds a PhD in Health Sciences from the Pontifical Catholic University of Paraná (PUCPR). He has served as director and vice president of the Brazilian Society of Cardiology – Regional Paraná and is currently the Ombudsman of the Regional Council of Medicine of Paraná. His contributions to cardiology and medical ethics have had a significant impact both nationally and internationally.
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