Lipid-lowering therapy after acute coronary syndromes: a multinational European survey.
Coron Artery Dis
; 2024 Sep 12.
Article
em En
| MEDLINE
| ID: mdl-39263716
ABSTRACT
BACKGROUND:
Recent guidelines on acute coronary syndromes (ACS) recommend initiating lipid-lowering therapy (LLT) as early as possible to obtain >50% low-density-lipoprotein cholesterol (LDL-c) reduction and an LDL-câ <â 1.4â mmol/l.METHODS:
A multinational European survey study of ACS patients between 2021-2022 and acquired data on LLT and lipid levels on admission and during 1-year posthospitalization. We compared plasma lipid changes and adherence to post-ACS lipid targets across two in-hospital LLT groups high-intensity statin (HIS) monotherapy (mono-HIS) and a combination of HIS and ezetimibe (combo-HIS).RESULTS:
Of 286 patients, 268 (94%) received in-hospital HIS and were included in the final analysis. Patients (median age 61.1 years) had a median baseline LDL-c of 3.3â mmol/l. Mono-HIS was the predominant in-hospital LLT (72.4%). In-hospital combo-HIS was administered in 27.6% of the cases. Patients from high-income countries (nâ =â 141) were more likely to receive in-hospital combo-HIS than patients from middle-income countries [nâ =â 127; 38.3% vs. 15.7% patients, Pâ <â 0.001). One-year post-ACS, 50 (26.5%) patients from the mono-HIS group received ezetimibe. The target of LDL-c ≤ 55â mg/dl was reached in 85 patients (31.7%), without significant difference between study groups [mono-HIS 56 (28.9%) and combo-HIS 29 (39.2%) patients, Pâ =â 0.10]. The target of >50% reduction was achieved more frequently among the combo-HIS group than in the mono-HIS group (50.0% vs. 29.9%, respectively, Pâ =â 0.002).CONCLUSION:
LDL-c targets were achieved in less than half of the patients post-ACS, regardless of the LLT regimen. Combo-HIS was initiated in-hospital post-ACS in only 28% and was associated with greater LDL-c reduction compared to a staged approach of mono-HIS with up-titration at follow-up.
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Base de dados:
MEDLINE
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article