Purpose: To investigate the attainment rates of recommended LDL-C target in a contemporary cohort of ACS patients in a tertiary university hospital and the associated incidence of major adverse cardiovascular events (MACE; cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, revascularizations) in patients followed for 1 year after the index ACS episode.
Methods: This is a cross-sectional substudy of IDEAL-LDL (Motivational Interviewing to Support LDL-C Therapeutic Goals and Lipid-Lowering Therapy Compliance in Patients with Acute Coronary Syndromes, ClinicalTrials.gov identifier NCT02927808).
Results: A total of 99 patients, hospitalized with ACS were studied. Mean LDL-C level differed significantly between admission and 1-year follow-up (110.2 mg/dl vs 75.7 mg/dl, p<0.001). Of patients, 46.4% (46) achieved an LDL-C <70 mg/dl and had a lower rate (vs non-achievers) of MACE during the follow-up (8.7% vs 26.4%, p=0.04). An LDL-C value > 100mg/dl at year was found in 19.3% (18) and was associated with incidence of MACE 27.7%.
Conclusions: Despite improvements in lipid profile, less than half of real-world patients attained the LDL-C goal at 1-year follow-up after an ACS. Lower LDL-C levels resulted in improved cardiovascular outcomes. Therefore, implementing the guidelines is of great clinical importance, but remains a challenge in everyday practice.