6533b852fe1ef96bd12aae47

RESEARCH PRODUCT

Lipid-lowering therapy and low-density lipoprotein cholesterol goal achievement in patients with acute coronary syndromes: The ACS patient pathway project

Gabriel StegJ. Wouter JukemaPepe ZamoranoFrancois SchieleUlrich LaufsFrançois MachUlf LandmesserTerje R. PedersenAlberico L. CatapanoAngela PirilloAzfar ZamanMichel FarnierMarco TubaroLuis Masana

subject

MaleAcute coronary syndromemedicine.medical_specialtyLow density lipoprotein cholesterolFamilial hypercholesterolemia030204 cardiovascular system & hematologyGuidelinesPatient pathwayLipid-lowering therapy03 medical and health sciences0302 clinical medicineInternal medicineInternal MedicinemedicineGoal achievementHumansIn patientLow-density lipoprotein cholesterol030212 general & internal medicineAgedmedicine.diagnostic_testbusiness.industryAnticholesteremic AgentsStatinsDisease ManagementGeneral MedicineCholesterol LDLLipid-lowering therapiesmedicine.diseaseFemaleAcute coronary syndromeHydroxymethylglutaryl-CoA Reductase InhibitorsCardiology and Cardiovascular MedicineLipid profilebusinessGoals

description

Background and aims: Post-acute coronary syndrome (ACS) patients are at very high risk for recurrent events and mortality, despite the availability of effective pharmacological approaches. Aim of this survey was to evaluate the compliance to ESC/EAS guidelines during the management of ACS patients and the effectiveness of secondary prevention in seven European countries.Methods: By means of an online questionnaire, data on 2775 ACS patients (either acute case or follow-up patients) were collected, including data on lipid profile, medications, follow-up visit planning, screening for familial hypercholesterolemia.Results: Lipid profiles were obtained for 91% of ACS patients in the acute phase, mostly within the first day of hospitalization (73%). During hospitalization, 93% of the patients received a lipid-lowering treatment; at discharge, only 66% of the patients received a high intensity statin therapy. At the first follow-up, most of the patients (77.6%) had LDL-C 70 mg/dL; among them, 41% had no change in their lipid-lowering therapies. Similar data were obtained during the second follow-up visit. The analysis of a subgroup of patients with at least 2 follow-up visits and known LDL-C levels showed that the percentage of patients at goal increased from 9% to 32%, and patients with LDL-C <100 mg/dL raised from 23% to 72%. Among acute cases, 44 were admitted with a diagnosis of familial hypercholesterolemia (FH); only 18% of the remaining patients were screened for FH.Conclusions: Contemporary lipid management of very high CV risk patients is sub-optimal despite available treatments. Greater efforts are warranted to optimize cardiovascular prevention.(c) 2021 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

yearjournalcountryeditionlanguage
2020-12-01
10.1016/j.atherosclerosissup.2021.01.009http://hdl.handle.net/10852/85650