Changes in lipid lowering medication and lipid levels over time in patients with stable coronary artery disease

To provide longitudinal data on the evolution of lipid levels and the intake of lipid-lowering therapies in patients with stable coronary artery disease.

Single-centre retrospective study with inclusion of 350 patients with a first coronary artery event in 2014 or earlier and outpatient cardiac clinic follow-up in 2015 and 2019. Lipid levels were collected within a time frame of 3 months of their visits.This retrospective study protocol (2020.086) was approved by the ethical committee and by the Data Privacy Officer of AZ Maria Middelares Ghent. For this type of study, formal consent is not required, following local law and regulations.

Average LDL levels were 82 (±26) mg/dl in 2015 and 70 (±24) mg/dl in 2019 (p < 0.001). Most patients included were already on statin treatment before inclusion in the trial (94%), with a significant increase in high-intensity statin use (45% vs. 58%) after a 5-year follow-up. At the same time, we observed a significant increase in ezetimibe use (in combination with statin therapy or in monotherapy) (8% vs. 22%) during follow-up. LDL ≤70 mg/dl was 34% in 2015 and 53% in 2019. LDL ≤55 mg/dl was 13% in 2015 and 28% in 2019.

This study shows significant intensification of lipid-lowering therapy use during follow-up, and a significant lipid level lowering after 5-year follow-up, in an outpatient cardiac clinic follow-up. Further improvement in lipid control is still desirable, especially after the European Society of Cardiology recommend stricter lipid levels in the 2021 Prevention Guidelines.