Table 2.
Rates of achieving LDL-C therapeutic targets in the MENA
| Study | Publication date | Number of patients, country | Inclusion criteria | CVD risk stratification | Achieving LDL-C target/ hypercholesterolemia control |
|---|---|---|---|---|---|
| DYSIS-Egypt[60]* | 2013 | 1466, Egypt | Age ≥45 years, and treated for ≥ 3 months with statins |
Very high: 85% High: 2.9% Moderate: 8.2% Low: 3.8% |
Very high and high (both): 28% Moderate: 50% Overall: 32.8%% |
| Saudi MOH Survey [61]# | 2014 | 10,735, Saudi Arabia | Age≥ 15 | – | 28.3%# |
| DYSIS [59]* | 2014 | 2,182, four MENA countries | Age ≥45 years, and treated for ≥ 3 months with statins |
Very high: 82.6% High: 2.7% Moderate: 10.3% Low: 4.4% |
Very high: 30.5% High: 43.1% Moderate: 71% Low: 100% Overall: 38.2% |
| CEPHEUS [62]$ | 2014 | 5276, Arabian Gulf Countries | Age≥ 18, taking LLT for 3 months, |
Very high: 32.9% High: 44.3% Medium-high:3.3% Medium-low:7.5% Low: 12.1% |
Very high: 31.9% High: 52.7% Medium-high:33% Medium-low: 81% Low: 91% Overall: 52% |
| CEPHEUS I Egypt [63]$ | 2014 | 1034, Egypt | Age≥ 18, taking LLT for 3 months |
Very high: 37.7% High: 34.7% Medium-high: 3.6% Medium-low: 16.0% Low: 8% |
Very high: 10.7% High: 34.2% Medium-high:7.9% Medium-low: 66.5% Low: 71.1% Overall: 32.5% |
| CEPHEUS II Egypt [64]* | 2017 | 1127, Egypt | Age≥ 18, taking LLT for 3 months, |
Very high: 65.2% High: 2.5% Moderate: 20% Low: 12.4% |
Very high: 22.3% High: 18.2% Moderate: 44.7% Low: 84.7% Overall: 34.4% |
| DYSIS II—Egypt [65]* | 2018 | 199, Egypt | Age≥ 18, hospitalized for ACS | – |
Very High: 5.1% High: 27.3% Moderate: 32.3% Low: 14.3% Overall: – |
| ICLPS [51]* | 2018 |
9049, 26.2% of them were from the MENA |
Treated for ≥ 3 months with any LLT |
Very high: 60.9% High: 33% Moderate: 5.2% Low: 0.9% |
Very high: 32.1% High: 51.9% Moderate: 55.7% Low: – Overall: 39.9% |
| Aghasizadeh et al. [66]+ | 2021 | 576, Iran | Treated with a statin for 12 months |
Extreme: 1.6% Very high: 58.5% High: 9.5% Moderate: 30.4% |
Extreme: 0% Very high: 28.2% High: 70.9% Moderate: 64.6% Overall: 42.9% |
| PACT-MEA [56] ++ | 2023 | 3726, 6/7 countries were from the MENA | Age≥ 18 years were diagnosed with T2D ≥ 180 days prior to study |
Very high: 29.9% High: 69.4%% |
High/very high: 30% |
ACS acute coronary syndrome, CEPHEUS centralized pan-Middle East survey on the undertreatment of hypercholesterolemia, CVD cardiovascular disease, DYSIS Dyslipidemia International Study, ICLPS International Cholesterol management Practice Study, LDL-C low-density lipoprotein-cholesterol, LLT lipid-lowering therapy, MENA Middle East and North Africa, MOH Ministry of Health
*The 2011 version of the European Society of Cardiology (ESC) guidelines was used to define cardiovascular risk and abnormalities in LDL-C and patients were risk-stratified according to the Systematic Coronary Risk Estimation (SCORE) Chart
#Hypercholesterolemia was considered controlled if measured cholesterol levels were below 6.2 mmol/L
$Patient risk categorization, respective LDL-C goals, and target attainment were determined according to the 2004 updated National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III)
+Atherosclerotic cardiovascular diseases risk level and treatment goals were determined according to the American Association of Clinical Endocrinologists (AACE) 2017 guidelines
++Cardiovascular risk categories were determined according to the European Society of Cardiology [ESC] 2021 guidelines, with an LDL-C target of<70 mg/dL