Prevalence of Lipid Abnormalities and Cholesterol Target Value Attainment in Patients with Stable and Acute Coronary Heart Disease in the United Arab Emirates

Study of Lipid-Modifying Therapy Use and Risk Factor Management in Patients With Dyslipidemia in Duhok City/Kurdistan Region, Iraq

Introduction Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of mortality globally, according to the World Health Organization. Research from the Middle East indicates that cardiovascular disease-related deaths in the region are among the highest worldwide. Multiple risk factors contribute to ASCVD. Elevated low-density lipoprotein cholesterol (LDL-C), often associated with hyperlipidemia, plays a pivotal role. The reduction of LDL cholesterol through statins has been extensively studied over the years and has demonstrated a significant decrease in rates of cardiovascular disease, particularly in high- and very high-risk groups. Study design This cross-sectional study enrolled 503 adult patients undergoing lipid-lowering therapy for primary and secondary prevention of ASCVD at the Azadi General & Teaching Hospital in Duhok City, Iraq. Data were collected from January 2, 2023, to October 31, 2023. The sample size was carefully determined to ensure a precise estimation of the primary outcome measure. Results Of the 503 patients aged 21-89 years, 315 (62.2%) were women. Among the 145 (28.8%) with ASCVD, 127 (87.5%) had coronary artery disease. Only 150 (29.8%) were on a high-intensity statin, compared to 293 (58.25%) on a moderate-intensity statin. In total, 155 (30.8%) attained LDL-C control (p<0.0001). Among the 207 with very high cardiovascular disease risk, only 10 (4.83%) achieved an LDL-C level below 55 mg/dl. Conclusion This study revealed inadequate management of LDL-C levels across various participant categories, particularly those classified as having high cardiovascular disease risk. Control of other risk factors (e.g., hypertension, diabetes, and metabolic syndrome) was overall very poor. Most participants were overweight or obese.

Current gaps in management and timely referral of cardiorenal complications among people with type 2 diabetes mellitus in the Middle East and African countries: Expert recommendations

The upsurge of type 2 diabetes mellitus is a major public health concern in the Middle East and North Africa (MENA) and Africa (AFR) region, with cardiorenal complications (CRCs) being the predominant cause of premature morbidity and mortality. High prevalence of cardiometabolic risk factors, lack of awareness among patients and physicians, deficient infrastructure, and economic constraints lead to a cascade of CRCs at a significantly earlier age in MENA and AFR. In this review, we present consensus recommendations by experts in MENA and AFR, highlighting region-specific challenges and potential solutions for management of CRCs. Health professionals who understand sociocultural barriers can significantly increase patient awareness and encourage health-seeking behavior through simple educational tools. Increasing physician knowledge on early identification of CRCs and personalized treatment based on risk stratification, alongside optimum glycemic control, can mitigate therapeutic inertia. Early diagnosis of high-risk people with regular and systematic monitoring of cardiorenal parameters, development of region-specific care pathways for timely referral to specialists, followed by guideline-recommended care with novel antidiabetics are imperative. Adherence to guideline-recommended care can catalyze utilization of sodium glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists with demonstrated cardiorenal benefits-thus paving the way for overcoming care gaps in a cost-effective manner. Leveraging digital technology like electronic medical records can help generate real-world data and provide insights on voids in adoption of newer antidiabetic medications. A patient-centric approach, collaborative care among physicians from different specialties, alongside involvement of policy makers are key for improving patient outcomes and quality of care in MENA and AFR.

The Diagnostic Accuracy of Cardiac Enzymes-Lipid Profile Ratio for Diagnosing Coronary Heart Disease in Chest Pain Patients

Background:

Lipid abnormalities increase Coronary Heart Disease (CHD) risk. Our developed indexes 1,2 were reported in scientific Journals. Here, we verified and evaluated the cardiac enzymes-lipid profile ratio's diagnostic value for diagnosing CHD patients.

Methods:

Lipid profiles and cardiac enzymes were estimated in all chest pain patients. The area under the receiver-operating characteristic curve (AUC) was used to evaluate the markers' diagnostic accuracy.

Results:

There were varieties of significant differences (P < 0.01- P < 0.0001) of Creatine Kinase MB (CK-MB) - lipid profile ratio and Troponin I-lipid profile ratio within the groups of chest pain patients. For discriminating between Non-Coronary Chest Pain (NCCP) and Stable Angina (SA) groups, the AUCs were the greatest for CK-MB- High-density Lipoprotein (HDL) ratio (0.62) and for Troponin I-HDL (0.62). Moreover, for discriminating between NCCP and Unstable Angina (UA) groups, the AUC was the greatest for CK-MB-HDL ratio (0.97). Also, for discriminating between NCCP and Acute Myocardial Infarction (AMI) groups, the AUC was the greatest for index 2 (0.99). Similarly, for discriminating between SA and UA groups, the AUC was the greatest for CK-MB-HDL ratio (0.90). For discriminating between SA and AMI groups, the AUC was the greatest for index 2 (0.97). Finally, for discriminating between UA and AMI groups, the AUC was the greatest for index 2 (0.78).

Conclusion:

Independent CK-MB-HDL ratio can be used as a good and simple index for diagnosing CHD in chest pain patients and discriminating between the different groups of these patients