Lipid-lowering therapy and low-density lipoprotein cholesterol goal attainment after acute coronary syndrome: a Danish population-based cohort study

BMC Cardiovascular Disorders

Mogens Lytken Larsen¹  Mads Nybo²  Anders Green³  Simone Møller Hede³  Marie Skov Kristensen⁴  Gunnar Gislason⁴  Annette Kjær Ersbøll⁴  Kristian Handberg Mikkelsen⁵ 

[1] Department of Cardiology, Aalborg University Hospital;Department of Clinical Biochemistry and Pharmacology, Odense University Hospital;Institute of Applied Economics and Health Research;National Institute of Public Health, University of Southern Denmark;Sanofi-Aventis Denmark A/S;

关键词: Low-density lipoprotein cholesterol;    LDL-C goal attainment;    Dyslipidemia;    Lipid-lowering therapy;    Acute coronary syndrome;    Population-based individual-level registers;   

DOI  :  10.1186/s12872-020-01616-9

来源: DOAJ

【 摘 要 】

Abstract Background Patients with acute coronary syndrome (ACS) are at high risk of recurrent cardiovascular (CV) event. The European guidelines recommend low-density lipoprotein cholesterol (LDL-C) levels < 1.8 mmol/L and early initiation of intensive lipid-lowering therapy (LLT) to reduce CV risk. In order to reduce the risk of further cardiac events, the study aimed to evaluate LDL-C goal attainment and LLT intensity in an incident ACS population. Methods A cohort study of patients with residency at Funen in Denmark at a first-ever ACS event registered within the period 2010–2015. Information on LLT use and LDL-C levels was extracted from national population registers and a Laboratory database at Odense University Hospital. Treatments and lipid patterns were evaluated during index hospitalization, at 6-month and 12-month follow-up. Results Among 3040 patients with an LDL-C measurement during index hospitalization, 40.7 and 39.0% attained the recommended LDL-C target value (< 1.8 mmol/L) within 6- and 12-month follow-up, respectively. During 6- and 12-month follow-up, a total of 89.2% (20.2%) and 88.4% (29.7%) used LLT (intensive LLT). Of the intensive LLT users, 43.4 and 47.7% reached the LDL-C target value at 6- and 12-month follow-up. The frequency of lipid monitoring was low: 69.5, 77.7 and 53.6% in patients with a first-ever ACS during index hospitalization, 6- and 12-month follow-up, respectively. Conclusion Using national health registers and laboratory data, a considerably gap was observed between treatment guidelines and clinical practice in the management of dyslipidemia leaving very high-risk patients without adequate lipid management strategy. Therefore, improved lipid management strategies aimed at reaching treatment targets are warranted.

【 授权许可】

Unknown