1. Ongoing statin therapy at hospitalization for acute myocardial infarction. Learnings for general practitioners.
Ghena Shabana
Specialist in Family Medicine
LäkarGruppen primary health care centre
Västerås, Sweden

2. Aim of the study
Determination of prevalence of ongoing statin treatment in acute myocardial infarction (AMI) patients, particularly those with diabetes, angina pectoris, prior myocardial infarction and prior stroke.
Real life patients we meet everyday at the GP clinic

3. Study population
Patients from the Vastmanland Myocardial Infarction Survery (VAMIS), n= 771 (77 % of eligible patients)
Men/ Women 537 / 234 (70/30%).
Mean age 66 years (Men 64/ Women 68).
Mention about the age difference between patients with and without statin treatment, mean age for AMI with statins 68.1 and those without 65 3

4. Basic characteristics
Statin +
n= 242
Statin –
n= 529
Total
n=771
P value
Known diabetes
n (%)
92 (70)
40 (30)
132
<0,001
Prior MI n (%)
125 (78)
36 (22)
161
Angina pectoris
125 (69)
57 (31)
182
Prior stroke n (%)
26 (53)
23 (47) 49
Hypertension n (%)
174 (41)
255 (59)
429
Current smoking n (%)
36 (20)
145 (80)
181
0,005
Example 132 patients with diabetes while 92 of them were treated with statins and 40 of them were not, which means 70 of all diabetis were on statins..

5. Blood lipid values in AMI patients
Cases n= 771
Statin +
n= 242
Statin –
n= 529
P value
Total Cholesterol (TC) mmol/L mean (SD)
4.4 (1.1)
5.5 (1.3)
<0,001
LDL-Cholesterol mmol/L mean (SD)
2.6 (1.7)
3.6 (1.1)
HDL-Cholesterol men mmol/L mean (SD)
1.02 (0.33)
1.05 (0.31)
HDL-Cholesterol women mmol/L mean (SD)
1.29 (0.42)
1.35 (0.45)
Triglycerides mmol/L mean (SD)
1.69 (1.09)
1.64 (1.17) ns 5

6. Recommended lipid levels
Product Medical Agency (Läkemedelsverket) recommends LDL cholesterol 2.5 mmol/L in high risk patients
European Society of Cardiology recommends
LDL cholesterol <1.8 mmol/L in AMI patients. *

7. Do we reach recommended levels of LDL-C ?
3 % of non-statin treated with LDL-Cholesterol < 1.8 mmol/L
22 % of statin treated with LDL-Cholesterol <1,8 mmol/L 7

8. Main conclusions
- Statins significantly reduces TC and LDL-C levels but not TG and HDL % of diabetics are not on statins as recommended when they get their first AMI !!! % of patients with prior AMI are not on statins as recommended % of patients with angina pectoris are not on statins as recommended. 8

9. Thank your for your attention Questions?9