Prior adherence to recommended lipid control targets in patients admitted for acute coronary syndrome
Laia Milà1, José A Barrabés1, Rosa-Maria Lidón1
1Unidad Coronaria, Servicio de Cardiología, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona, CIBERCV, Barcelona, Spain.
Insights
Optimal lipid control remains a challenge for acute coronary syndrome patients. Only 34.2% achieved recommended low-density lipoprotein-cholesterol (LDL-C) targets, highlighting a need for improved cardiovascular risk management.
Area of Science:
- Cardiology
- Lipid Metabolism
- Preventive Medicine
Background:
- Optimal lipid control is crucial but difficult to achieve.
- European Society of Cardiology (ESC) guidelines set targets for low-density lipoprotein-cholesterol (LDL-C).
- Acute coronary syndrome (ACS) patients often have high cardiovascular risk.
Purpose of the Study:
- To assess pre-admission LDL-C control in patients hospitalized for ACS.
- To determine the frequency of achieving ESC targets for LDL-C.
- To identify predictors of inadequate lipid control in this population.
Main Methods:
- Fasting LDL-C levels were measured in 3164 ACS patients (2010-2017).
- Adequate LDL-C control was defined by individual cardiovascular risk.
- Statistical analysis identified predictors of inadequate and adequate control.
Main Results:
- Median LDL-C was 104 mg/dL; only 34.2% met recommended targets.
- Adequate LDL-C control increased moderately over the study period.
- Inadequate control was linked to higher patient risk, dyslipidemia, smoking, diabetes, and BMI ≥ 25. Statin therapy correlated with adequate control.
Conclusions:
- Slightly over one-third of ACS patients achieve LDL-C goals upon admission.
- Significant opportunities exist for improving primary and secondary prevention strategies.
- Overweight patients and those with multiple risk factors require intensified lipid management.
Introduction And Objectives:
Optimal lipid control is difficult to attain. We assessed preadmission achievement of the European Society of Cardiology targets for low-density lipoprotein-cholesterol (LDL-C) control in patients admitted for acute coronary syndrome.
Methods:
Fasting LDL-C levels were measured in 3164 patients admitted between 2010 and 2017. We assessed the frequency of adequate LDL-C control, with targets defined according to individual cardiovascular risk, and the predictors of inadequate control.
Results:
The median LDL-C value was 104 (80-130) mg/dL. Most patients had high or very high cardiovascular risk and only 34.2% had LDL-C levels below the recommended target for their estimated risk. Achievement of LDL-C goals increased moderately throughout the study period. Adequate LDL-C control was inversely associated with patient risk. Dyslipidemia, active smoking, diabetes mellitus, and body mass index ≥ 25 were independent predictors of inadequate lipid control, while ongoing statin therapy was associated with adequate control.
Conclusions:
Only slightly more than one third of patients admitted for acute coronary syndrome meet recommended LDL-C targets on admission. There is broad scope for improvement in primary and secondary prevention, especially among patients who are overweight or have other cardiovascular risk factors.
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