Development of In-Hospital and Discharge Protocols for Optimal Lipid-Lowering Strategies in Patients with Acute
Öner Özdoğan1, Meral Kayıkçıoğlu2, Barış Güngör3
1Department of Cardiology, University of Health Sciences, Izmir Faculty of Medicine, Izmir, Türkiye.
Insights
Expert cardiologists developed new lipid management guidelines for acute coronary syndrome (ACS) patients in Türkiye. These recommendations aim to improve low-density lipoprotein cholesterol (LDL-C) control in real-world practice.
Area of Science:
- Cardiology
- Lipidology
- Public Health
Background:
- Current guidelines recommend low-density lipoprotein cholesterol (LDL-C) targets for acute coronary syndrome (ACS) patients, but these goals are frequently unmet.
- Real-world practice in Türkiye presents unique challenges for optimal lipid management in ACS patients.
- A need exists for standardized, country-specific strategies to improve lipid-lowering therapy adherence and effectiveness.
Purpose of the Study:
- To present expert recommendations for in-hospital and post-discharge lipid management in ACS patients in Türkiye.
- To develop standardized algorithms for lipid management during the first year following an ACS event.
- To address practical issues within the Turkish healthcare infrastructure for ACS patient lipid care.
Main Methods:
- A consensus-based approach was used, involving expert cardiologists and lipidologists with extensive experience in national working groups.
- Consideration was given to the Turkish healthcare infrastructure and real-world practice challenges.
- Novel standardized algorithms were developed for the management of lipid-lowering therapy in ACS patients.
Main Results:
- The proposed strategy includes in-hospital lipid profile assessment and initiation of statin therapy.
- Recommendations cover managing patients with potential familial hypercholesterolemia or recurrent cardiovascular events.
- The strategy incorporates the role of specialized nurses, patient follow-up cards, and patient education.
Conclusions:
- A country-specific approach to lipid management in ACS patients in Türkiye is proposed.
- The recommendations cover both in-hospital and post-discharge phases, including treatment modifications based on LDL-C levels.
- Further research is required to validate and implement these recommendations in daily clinical practice.
Abstract:
Although guidelines strongly recommend low levels of low-density lipoprotein cholesterol (LDL-C) in patients with acute coronary syndrome (ACS), these goals are not achieved in many patients. We present expert recommendations for the in-hospital and post-discharge management of lipid-lowering therapy in ACS patients in Türkiye. A group of expert cardiologists comprising members of the Turkish Society of Cardiology and leading lipidologists who have all worked in national cardiology lipid working groups for at least 4 years, considered the optimal approach to lipid management in ACS patients in Türkiye, taking into account Turkish healthcare infrastructure and issues from real-world practice. Novel standardized algorithms covering the first year after an ACS event were developed. The main elements of the proposed approach are summarized. The in-hospital strategy includes lipid profile assessments and commencement of statin therapy, including appropriate measures for patients with possible familial hypercholesterolemia or with a history of recurrent cardiovascular events. The role of a specially-trained nurse, use of a patient follow-up card, and the provision of patient information and referrals to affiliated healthcare professionals, are covered. The post-discharge strategy covers follow-up visits to monitor the patient's progress and recommends timepoints at which modifications to treatment (based on LDL-C levels) should be made. A country-specific approach to lipid management in ACS patients in Türkiye is proposed. Further work is needed to determine the best way to implement the strategy, and to validate the recommendations and their application in daily practice.
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