The majority of patients with acute coronary syndrome (ACS) treated with statins were found to have low-density lipoproteins-cholesterol (LDL-C) levels above those recommended by current guidelines, according to a study published in Atherosclerosis.

In this retrospective study, electronic medical record data from urban and rural healthcare centers in 2 regions of Finland were examined. Data analyzed included inpatient episodes, outpatient visits, prescriptions, invasive procedures, and LDL-C results for patients with ACS who visited those centers between 2011 and 2015 (n=662; median age, 71 years; 65% men). LDL-C levels at baseline, first follow-up, and final follow-up (up to 24 months) were examined to assess the impact of lipid-lowering therapy on the prevention of coronary artery disease (CAD) in patients with ACS.

In this cohort, 58% of patients had been prescribed a lipid-lowering therapy before experiencing ACS. At the final follow-up, 47% and 28% of patients were taking moderate- or high-intensity lipid-lowering therapy, respectively, 32% of patients achieved the guideline-recommended LDL-C target (ie, <1.8 mmol/L).


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A total of 72% and 47% of patients with baseline LDL-C levels >3.0 mmol/L and between 2.5 mmol/L and 3.0 mmol/L, respectively had their LDL-C levels reduced by >25% at the last follow-up. From the first to the last follow-up, 21% of patients fluctuated between being on or above the 1.8 mmol/L LDL-C target.

Study limitations include its retrospective design and the lack of data on statin adherence and CAD risk factors (eg, obesity, smoking, and blood pressure) that could have affected LDL-C levels.

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 “LDL-C levels should be monitored at least on a yearly basis on follow-up visits and treatment adapted accordingly,” noted the study authors.

Disclosure: This clinical trial was supported by Amgen. Please see the original reference for a full list of authors’ disclosures.

Reference

Leskelä RL, Torvinen A, Rissanen TT, et al. Outcomes of lipid control in secondary prevention of coronary artery disease in Finland: a 24-month follow-up after acute coronary syndrome. Atherosclerosis. 2020;296:4-10.