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Medical and psychosocial factors and unfavourable low-density lipoprotein cholesterol control in coronary patients
Drammen Hospital, Norway.
Drammen Hospital, Norway ; University of Oslo, Norway.
Vestfold Hospital, Norway.
Vestfold Hospital, Norway ; University of Oslo, Norway.
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2017 (English)In: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 24, no 9, 981-989 p.Article in journal (Refereed) Published
Abstract [en]

Objective Understanding the determinants of low-density lipoprotein cholesterol (LDL-C) control constitutes the basis of modelling interventions for optimal lipid control and prognosis. We aim to identify medical and psychosocial (study) factors associated with unfavourable LDL-C control in coronary patients. Methods A cross-sectional explorative study used logistic and linear regression analysis to investigate the association between study factors and LDL-C in 1095 patients, hospitalized with myocardial infarction and/or a coronary revascularization procedure. Data were collected from hospital records, a comprehensive self-report questionnaire, clinical examination and blood samples after 2-36 months follow-up. Results Fifty-seven per cent did not reach the LDL-C target of 1.8 mmol/l at follow-up. Low socioeconomic status and psychosocial factors were not associated with failure to reach the LDL-C target. Statin specific side-effects (odds ratio 3.23), low statin adherence (odds ratio 3.07), coronary artery by-pass graft operation as index treatment (odds ratio 1.95), ≥ 1 coronary event prior to the index event (odds ratio 1.81), female gender (odds ratio 1.80), moderate- or low-intensity statin therapy (odds ratio 1.62) and eating fish < 3 times/week (odds ratio 1.56) were statistically significantly associated with failure to reach the LDL-C target, in adjusted analyses. Only side-effects (standardized β 0.180), low statin adherence (β 0.209) and moderate- or low-intensity statin therapy (β 0.228) were associated with LDL-C in continuous analyses. Conclusions Statin specific side-effects, low statin adherence and moderate- or low-intensity statin therapy were the major factors associated with unfavourable LDL-C control. Interventions to improve LDL-C should ensure adherence and prescription of sufficiently potent statins, and address side-effects appropriately. © European Society of Cardiology 2017.

Place, publisher, year, edition, pages
Sage Publications, 2017. Vol. 24, no 9, 981-989 p.
Keyword [en]
Coronary heart disease, Drug adherence, Low-density lipoprotein cholesterol, Psychosocial factors, Secondary prevention
National Category
Cardiac and Cardiovascular Systems
Research subject
Health and Caring Sciences
Identifiers
URN: urn:nbn:se:lnu:diva-64660DOI: 10.1177/2047487317693134ISI: 000401147700011PubMedID: 28196429Scopus ID: 2-s2.0-85019243441OAI: oai:DiVA.org:lnu-64660DiVA: diva2:1104937
Available from: 2017-06-02 Created: 2017-06-02 Last updated: 2017-07-19Bibliographically approved

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CiteExportLink to record
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Citation style
  • apa
  • harvard1
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  • modern-language-association-8th-edition
  • vancouver
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More styles
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