Lipid-Lowering Treatment and the Lipid Goals Attainment in Patients with a Very High Cardiovascular Risk

Area of Science:

• Cardiology
• Lipidology
• Public Health

Background:

• Hypercholesterolemia is a primary cardiovascular risk factor.
• High-dose statin therapy is common for patients with very high cardiovascular risk.
• Achieving target Low-Density Lipoprotein Cholesterol (LDL-C) levels is crucial for reducing cardiovascular events.

Purpose of the Study:

• To evaluate the achievement of the LDL-C therapeutic goal (< 55 mg%) in patients with very high cardiovascular risk treated with high-dose statins after acute myocardial infarction (AMI).
• To assess the impact of LDL-C goal attainment on mortality within 12 months post-AMI.

Main Methods:

• A cohort of 1413 patients hospitalized for AMI and treated with high-dose atorvastatin (≥ 40 mg) or rosuvastatin (≥ 20 mg) was studied.
• Lipid profiles were measured on admission and within 12 months post-AMI.
• Mortality rates were analyzed in relation to LDL-C levels at follow-up.

Main Results:

• Only 13.2% of patients achieved the LDL-C goal (< 55 mg%) during hospitalization.
• At 12-month follow-up (in 46% of patients), 39% achieved the LDL-C goal.
• 18.26% of patients died within 12 months; the lowest mortality (11.02%) was observed in patients achieving LDL-C < 55 mg% at follow-up.
• Only 4.3% of patients received ezetimibe in addition to statins.

Conclusions:

• Attainment of LDL-C goals with high-dose statins alone is insufficient in very high-risk patients post-AMI.
• Combination therapy with statins and ezetimibe should be considered more frequently for these patients.
• Achieving low LDL-C levels at follow-up is associated with reduced 12-month mortality.