Ntila, Patience Mtwakazi2025-04-032023-11Ntila, Patience Mtwakazi. (2023). Secondary prevention and management of dyslipidaemia in patients with coronary artery disease on statin therapy in a tertiary academic centre in Johannesburg. [Masters dissertation, University of the Witwatersrand, Johannesburg]. WIReDSpace. https://hdl.handle.net/10539/44570https://hdl.handle.net/10539/44570A research report submitted in partial fulfilment of the requirements for the degree of Master of Medicine, to the Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, 2023.Background and aims: Low-density lipoprotein-cholesterol (LDL-C) is essential in initiating atherosclerosis, and its control is paramount in reducing future major adverse cardiovascular events. New guidelines recommend an LDL-C target of <1.4 mmol in patients with atherosclerotic cardiovascular disease. However, whether patients on statin therapy achieve these LDL-C targets in South African public hospitals is unknown. Therefore, this study aimed to determine the achievement of LDL-C targets in patients with coronary artery disease (CAD) on statin treatment at a public tertiary academic hospital. Methods: We analysed data from 458 patients with angiographically confirmed CAD on statin therapy, comparing index admission to the most recent follow-up LDL-C level. Results: After a median duration of 17 months (interquartile range: 7 - 31), 93 (20.3%) patients achieved the LDL-C target. Among the 329 (71.8%) patients on a high-potency statin, 76 (23.2%) achieved the LDL-C target. On univariable logistic regression analysis, a history of previous CAD or stroke [odds ratio (OR):1.73; 95% confidence interval (CI): 1.05 - 2.85; p value= 0.031], presentation with non-ST-elevation myocardial infarction [OR:0.55; 95% CI: 0.34 - 0.90; p = 0.017] and unstable angina [OR: 2.25; 95% CI: 1.08 to 4.70; p = 0.030] were related with failure to attain LDL-C targets. Conclusions: Only 20.3% of all patients with atherosclerotic CAD and 23.2% on high-intensity statins achieved the guideline-recommended LDL-C target.en©2023 University of the Witwatersrand, Johannesburg. All rights reserved. The copyright in this work vests in the University of the Witwatersrand, Johannesburg. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of University of the Witwatersrand, Johannesburg.Low-density lipoproteinDyslipidaemiaStatinCoronary artery diseaseLow-and-middle-income countryUCTDDissertationUniversity of the Witwatersrand, JohannesburgSDG-3: Good health and well-beingSDG-4: Quality education