TY - JOUR
T1 - Lipid-lowering therapy and low-density lipoprotein cholesterol goal achievement in patients with acute coronary syndromes
T2 - The ACS patient pathway project
AU - Landmesser, Ulf
AU - Pirillo, Angela
AU - Farnier, Michel
AU - Jukema, J. Wouter
AU - Laufs, Ulrich
AU - Mach, François
AU - Masana, Luis
AU - Pedersen, Terje R.
AU - Schiele, François
AU - Steg, Gabriel
AU - Tubaro, Marco
AU - Zaman, Azfar
AU - Zamorano, Pepe
AU - Catapano, Alberico L.
N1 - Funding Information:
The presentation of data contained in this work at the annual meeting of SITeCS (Societ? Italiana di Terapia Clinica e Sperimentale) was realized with the institutional support of Sanofi. The sponsor had no role in the design, interpretation, decision to publish, or writing the manuscript. The work of ALC has been supported by Ministry of Health - Ricerca Corrente - IRCCS MultiMedica, PRIN 2017H5F943 and ERANET ER-2017-2364981. This article is part of a Supplement entitled ?Plasma lipids and cardiovascular risk: Nutritional and therapeutic approaches? published with support from Societ? Italiana di Terapia Clinica e Sperimentale (SITeCS).
Publisher Copyright:
© 2021 The Authors
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2020/12
Y1 - 2020/12
N2 - Background and aims: Post-acute coronary syndrome (ACS) patients are at very high risk for recurrent events and mortality, despite the availability of effective pharmacological approaches. Aim of this survey was to evaluate the compliance to ESC/EAS guidelines during the management of ACS patients and the effectiveness of secondary prevention in seven European countries. Methods: By means of an online questionnaire, data on 2775 ACS patients (either acute case or follow-up patients) were collected, including data on lipid profile, medications, follow-up visit planning, screening for familial hypercholesterolemia. Results: Lipid profiles were obtained for 91% of ACS patients in the acute phase, mostly within the first day of hospitalization (73%). During hospitalization, 93% of the patients received a lipid-lowering treatment; at discharge, only 66% of the patients received a high intensity statin therapy. At the first follow-up, most of the patients (77.6%) had LDL-C >70 mg/dL; among them, 41% had no change in their lipid-lowering therapies. Similar data were obtained during the second follow-up visit. The analysis of a subgroup of patients with at least 2 follow-up visits and known LDL-C levels showed that the percentage of patients at goal increased from 9% to 32%, and patients with LDL-C <100 mg/dL raised from 23% to 72%. Among acute cases, 44 were admitted with a diagnosis of familial hypercholesterolemia (FH); only 18% of the remaining patients were screened for FH. Conclusions: Contemporary lipid management of very high CV risk patients is sub-optimal despite available treatments. Greater efforts are warranted to optimize cardiovascular prevention.
AB - Background and aims: Post-acute coronary syndrome (ACS) patients are at very high risk for recurrent events and mortality, despite the availability of effective pharmacological approaches. Aim of this survey was to evaluate the compliance to ESC/EAS guidelines during the management of ACS patients and the effectiveness of secondary prevention in seven European countries. Methods: By means of an online questionnaire, data on 2775 ACS patients (either acute case or follow-up patients) were collected, including data on lipid profile, medications, follow-up visit planning, screening for familial hypercholesterolemia. Results: Lipid profiles were obtained for 91% of ACS patients in the acute phase, mostly within the first day of hospitalization (73%). During hospitalization, 93% of the patients received a lipid-lowering treatment; at discharge, only 66% of the patients received a high intensity statin therapy. At the first follow-up, most of the patients (77.6%) had LDL-C >70 mg/dL; among them, 41% had no change in their lipid-lowering therapies. Similar data were obtained during the second follow-up visit. The analysis of a subgroup of patients with at least 2 follow-up visits and known LDL-C levels showed that the percentage of patients at goal increased from 9% to 32%, and patients with LDL-C <100 mg/dL raised from 23% to 72%. Among acute cases, 44 were admitted with a diagnosis of familial hypercholesterolemia (FH); only 18% of the remaining patients were screened for FH. Conclusions: Contemporary lipid management of very high CV risk patients is sub-optimal despite available treatments. Greater efforts are warranted to optimize cardiovascular prevention.
KW - Acute coronary syndrome
KW - Guidelines
KW - Lipid-lowering therapies
KW - Low-density lipoprotein cholesterol
KW - Statins
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U2 - 10.1016/j.atherosclerosissup.2021.01.009
DO - 10.1016/j.atherosclerosissup.2021.01.009
M3 - Article
AN - SCOPUS:85101053415
VL - 42
SP - e49-e58
JO - Atherosclerosis Supplements
JF - Atherosclerosis Supplements
SN - 1567-5688
ER -