ArticleInternational journal of cardiology. Cardiovascular risk and prevention2025
Lipid-lowering prescription patterns after a non-fatal acute coronary syndrome: A retrospective cohort study.
Article in International journal of cardiology. Cardiovascular risk and prevention, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: After an acute atherosclerotic cardiovascular event, high-intensity lipid-lowering therapy (LLT) is needed to reduce recurrence risk. This study aimed to describe LLT prescription patterns and LDL-C levels change after non-fatal acute coronary syndrome (ACS) events and to determine if the recommended goals for LDL-C levels were achieved. Methods: Retrospective cohort study using electronic health records (EHR) of Unidade Local de Saúde de Matosinhos between 2015 and 2023. Participants were adults aged 40-80 years, with a non-fatal ACS hospitalization between 2016 and 2022 (index date); ≥1 general practice appointment in the three years before ACS; and one-year follow-up post-ACS. Sub-analyses focused on gender, age (<and ≥65 years), and whether patients met LDL-C control (55 mg/dL) at one-year post-ACS. Results: Of 544 patients, 270 (49.6 %) were under 65 years, and 164 (30.1 %) were females. Before the ACS, 71.1 % of men and 56.7 % of women had no previous LLT prescription and younger patients showed poorer LDL-C control (132(IQR 64)mg/dL) than older patients (102(IQR 50)mg/dL). One-year post-ACS, only 11.3 % of males and 8.5 % of females met LDL-C target. The proportion of patients without LLT decreased from 66.7 % at baseline to 13.6 % post-ACS. High-intensity LLT prescriptions increased from 2.4 % to 16.5 %, while moderate-intensity LLT remained predominant (65.8 %). Still, 89.5 % of patients had uncontrolled LDL-C levels. Conclusion: Despite initiating/intensifying LLT, one year after ACS most patients did not achieve LDL-C goals. This indicates a significant gap in guideline implementation in clinical practice.
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