Key result
Men with first-time AMI are ~11% more likely than women to meet ACC/AHA statin guidelines.
Why the study?
Statin eligibility according to 2013 ACC/AHA and 2016 USPSTF guidelines had not been evaluated and compared between men and women among Middle Eastern patients admitted with AMI without prior statin use.
Does statin eligibility prior to first-time AMI differ between men and women according to ACC/AHA and USPSTF guidelines?
Observational (n=774)
Yes
Does statin eligibility prior to first-time AMI differ between men and women according to ACC/AHA and USPSTF guidelines?
A large proportion of Jordanian patients presenting with a first-time AMI were already eligible for primary prevention statin therapy prior to admission, highlighting a missed opportunity for prevention, particularly among men.
Answers are grounded in this paper and cite their sources.
May indicate under-recognition of statin need in women pre-AMI; leaves open whether sex-specific thresholds improve primary prevention.
The objectives of this study were to evaluate statin eligibility among Middle Eastern patients admitted with acute myocardial infarction (AMI) who had no prior use of statin therapy, according to 2013 ACC/AHA and 2016 USPSTF guidelines, and to compare statin eligibility between men and women. This was a retrospective multicenter observational study of all adult patients admitted to five tertiary care centers in Jordan with a first-time AMI, no prior cardiovascular disease, and no prior statin use between April 2018 and June 2019. Ten-year atherosclerotic cardiovascular disease (ASCVD) risk score was estimated based on ACC/AHA risk score. A total of 774 patients met the inclusion criteria. The mean age was 55 years ( <a:math xmlns:a="http://www.w3.org/1998/Math/MathML" id="M1"> <a:mtext>SD</a:mtext> <a:mo>±</a:mo> <a:mn>11.3</a:mn> </a:math> ), 120 (15.5%) were women, and 688 (88.9%) had at least one risk factor of cardiovascular disease. Compared to men, women were more likely to be older; had a history of diabetes, hypertension, and hypercholesterolemia; and had higher body mass index, systolic blood pressure, total cholesterol, and high-density lipoproteins. Compared to women, men were more likely to have a higher 10-year ASCVD risk score (14.0% vs. 17.8%, <c:math xmlns:c="http://www.w3.org/1998/Math/MathML" id="M2"> <c:mi>p</c:mi> <c:mo>=</c:mo> <c:mn>0.005</c:mn> </c:math> ), and more men had a 10-year ASCVD risk score of ≥7.5% and ≥10%. The proportion of patients eligible for statin therapy was 80.2% based on the 2013 ACC/AHA guidelines and 59.5% based on the USPSTF guidelines. A higher proportion of men were eligible for statin therapy compared to women, based on both the 2013 ACC/AHA (81.4% vs. 73.5%, <e:math xmlns:e="http://www.w3.org/1998/Math/MathML" id="M3"> <e:mi>p</e:mi> <e:mo>=</e:mo> <e:mn>0.050</e:mn> </e:math> ) and USPSTF guidelines (62.0% vs. 45.2%, <g:math xmlns:g="http://www.w3.org/1998/Math/MathML" id="M4"> <g:mi>p</g:mi> <g:mo>=</g:mo> <g:mn>0.001</g:mn> </g:math> ). Among Middle Easterners, over half of patients with AMI would have been eligible for statin therapy prior to admission based on the 2013 ACC/AHA and USPSTF guidelines, with the presence of gender gap. Adopting these guidelines in clinical practice might positively impact primary cardiovascular preventive strategies in this region.
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Ibdah et al. (2023) conducted an observational in Acute Myocardial Infarction (n=774). Male gender vs. Female gender was evaluated on Statin eligibility based on 2013 ACC/AHA guidelines (p=0.050). Male patients with first-time AMI were more likely to be eligible for statin therapy than women based on ACC/AHA (81.4% vs 73.5%, p=0.050) and USPSTF guidelines (62.0% vs 45.2%, p=0.001).
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