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Attainment of LDL-C target and cardiovascular outcomes a year after an acute coronary syndrome

Session Poster Session 2

Speaker Diamantis Kosmidis

Congress : ESC Preventive Cardiology (Formerly EuroPrevent) 2019

  • Topic : preventive cardiology
  • Sub-topic : Secondary Prevention
  • Session type : Poster Session
  • FP Number : P530

Authors : S Zafeiropoulos (Thessaloniki,GR), D Kosmidis (Thessaloniki,GR), A Kartas (Thessaloniki,GR), I Farmakis (Thessaloniki,GR), V Nevras (Thessaloniki,GR), A Boulmpou (Thessaloniki,GR), I Papadimitriou (Thessaloniki,GR), E Markidis (Thessaloniki,GR), A Tampaki (Thessaloniki,GR), A Vlachou (Thessaloniki,GR), N Ioakeimidis (Thessaloniki,GR), R Tzimou (Thessaloniki,GR), G Giannakoulas (Thessaloniki,GR)

S Zafeiropoulos1 , D Kosmidis1 , A Kartas1 , I Farmakis1 , V Nevras1 , A Boulmpou1 , I Papadimitriou1 , E Markidis1 , A Tampaki1 , A Vlachou1 , N Ioakeimidis1 , R Tzimou1 , G Giannakoulas1 , 1Ahepa University Hospital, 1st Cardiology Department - Thessaloniki - Greece ,


Background: Survivors of Acute Coronary Syndromes (ACS) are at very high risk for subsequent cardiovascular events. Low LDL-Cholesterol (LDL-C) levels are associated with improved clinical outcomes in this population. European guidelines advocate achieving an LDL-C level below 70mg/dl post-ACS. However, the extent to which these guidelines are adhered to in daily clinical practice is unclear.

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, 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.

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