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. 2025 Apr 29;17(4):e83200.
doi: 10.7759/cureus.83200. eCollection 2025 Apr.

Screening for Dyslipidemia Among Patients Admitted With Acute Coronary Syndrome at the Jakaya Kikwete Cardiac Institute, Tanzania: A Retrospective Cohort Study

Naki Kiroga  1 , Zahid Khan  2   3   4
Affiliations

Screening for Dyslipidemia Among Patients Admitted With Acute Coronary Syndrome at the Jakaya Kikwete Cardiac Institute, Tanzania: A Retrospective Cohort Study

Naki Kiroga et al. Cureus. .

Abstract

Introduction: Dyslipidemia remains a significant risk factor for atherosclerosis and the development of acute coronary syndrome (ACS). Consistent data have demonstrated challenging lipid control according to the European Society of Cardiology (ESC) guideline-directed target low-density lipoprotein cholesterol (LDL-C) level. The exact prevalence of dyslipidemia in Tanzania remains unclear, although it is known to be quite high, and higher in urban than in rural areas. This study aimed to evaluate the current practice of lipid assessment in patients admitted with ACS and compliance with national and international guidelines.

Methodology: This retrospective hospital-based cohort study aimed to determine the current practice of dyslipidemia screening in patients with ACS admitted to the Jakaya Kikwete Cardiac Institute (JKCI) and evaluate their adherence to national and international recommended guidelines, such as ESC and American Heart Association guidelines. All patients admitted to the JKCI from June 2023 to June 2024, aged 18 years or older, and presenting with ACS, were included in this study. Data were collected using a prestructured tool created with Google Forms (Google, Mountain View, CA). Data extraction was performed in MS Excel (Microsoft Corporation, Redmond, WA) and then transferred to R software (R Foundation for Statistical Computing, Vienna, Austria) for analysis. This information is summarized in tables, graphs, and frequencies.

Results: This study included 124 patients diagnosed with ACS admitted to the JKCI center. Of this cohort, 58 (47%) patients had their LDL-C levels checked within 48 hours of presentation. The follow-up of lipids after admission was documented in 10% of the patients. Only 9.5% achieved the guideline-recommended LDL-C goal. Most patients were initiated on and maintained on a high-intensity statin, with no data on the use of nonstatin therapy.

Conclusion: The findings of this study have mirrored many irregularities in the current practice of dyslipidemia screening among patients with ACS admitted to JKCI. This study also highlighted the local nonadherence to national and international recommended guidelines, which, in turn, undermines secondary prevention of cardiovascular events. Further larger multicentered studies are recommended to assess the scope of the problem to reduce the burden and risk of future events.

Keywords: acute coronary syndrome; atherosclerotic cardiovascular disease (ascvd); european society of cardiology/european atherosclerosis society; improved reduction of outcomes: vytorin efficacy international trial (improve it); jakaya kikwete cardiac institute; justification for the use of statins in prevention: an intervention trial evaluating rosuvastatin; low-density lipoprotein cholesterol (ldl-c); non-st-segment elevation myocardial infarction (nstemi); pravastatin or atorvastatin evaluation and infection therapy-thrombolysis in myocardial infarction 22; proprotein convertase subtilisin/kexin type 9 (pcsk9) inhibitors.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Jakaya Kikwete Cardiac Institute, Tanzania issued approval AB.123/307/01L/11. This letters serves as an official document that permits you to do the above mentioned task as requested. It is our sincere hope that you will adhere to the rules and regulations governing good clinical practice. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Patients' underlying comorbidities
T2DM: type 2 diabetes mellitus; CKD: chronic kidney disease
Figure 2
Figure 2. LDL-C baseline and follow-up assessment
LDL-C: low-density lipoprotein cholesterol
Figure 3
Figure 3. Percentage of patients that screened for all lipids on admission
LDL-C: low-density lipoprotein cholesterol; HDL-C: low-density lipoprotein cholesterol
Figure 4
Figure 4. Proportion of patients showing the time of the prescription of statin in patients with acute coronary syndrome
Figure 5
Figure 5. Pattern of statin therapy
LDL-C: low-density lipoprotein cholesterol
See this image and copyright information in PMC

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