ArticleEuropean heart journal. Acute cardiovascular care2024
Quality control to improve LDL-cholesterol management in patients with acute coronary syndromes based on the ACS EuroPath IV project.
Article in European heart journal. Acute cardiovascular care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed, 7 citations in OpenAlex.
- Trends in lipid-lowering therapies in acute coronary syndromes after Chinese new insurance policy: a real-world analysis.BMC medicine · 2026Observational
- Optimizing care and quality indicators in the management of patients with acute ischaemic heart disease and atherothrombotic stroke: measuring to improve.Drugs in context · 2026Article
- Impact of a Physician-led Strike Early-Strike Strong Lipid-Lowering Protocol Incorporating PCSK9 Inhibitors for Patients with Acute Myocardial Infarction.Journal of atherosclerosis and thrombosis · 2025Article
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Authors and funding
7 authors at 7 institutions in 7 countries.
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Abstract
aimsWe performed quality control of lipid-lowering therapy (LLT) in patients with acute coronary syndrome (ACS), with a view to proposing corrective actions. METHODS AND
resultsUsing a Define Measure Analysis Improve Control (DMAIC) approach applied to data from the ACS EuroPath IV survey, we measured attainment of two quality indicators (QIs) related to lipid-lowering treatment: (i) prescription of high-intensity statins (or equipotent treatment) before discharge, and (ii) proportion with LDL-cholesterol <55 mg/dL (1.4 mmol/L) during follow-up. A total of 530 European cardiologists responded and provided data for up to 5 patients from their centre, for acute and follow-up phases. Corrective measures are proposed to increase the rate of attainment of both QIs. Attainment of the first QI was measured in 929 acute-phase patients, 99% had LLT prescribed at discharge and 75% of patients fulfilled the first QI. Attainment of the second QI was assessed in 1721 patients with follow-up. The second QI was reached in 31% of patients. The DMAIC approach yielded 10 potential changes in prescription, 3 for the first and 7 for the second QI. The overall strategy is 'Fire to Target', i.e. early intensification of the LLT using statins, ezetimibe, bempedoic acid, and proprotein convertase subtilisin/kexin type-9 inhibitors, and is presented as an algorithm for routine application.
conclusionQuality control for LLT, based on the ACS EuroPath IV survey, detected 10 potential changes in prescription that could enhance attainment of 2 QIs. Whether the Fire to Target strategy will be adopted and effective needs to be assessed in further steps of the EuroPath Quality programme.
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