Authors

• Zrinka Planinić — Klinička bolnica “Sveti Duh”, Zagreb, Hrvatska — ORCID: 0000-0001-8664-3338
• Ante Pašalić — Klinička bolnica “Sveti Duh”, Zagreb, Hrvatska — ORCID: 0000-0001-5989-6495
• Tea Friščić — Klinička bolnica “Sveti Duh”, Zagreb, Hrvatska — ORCID: 0000-0003-3189-8661
• Marko Perčić — Klinička bolnica “Sveti Duh”, Zagreb, Hrvatska — ORCID: 0000-0001-7904-8899
• Dario Gulin — Klinička bolnica “Sveti Duh”, Zagreb, Hrvatska — ORCID: 0000-0001-8502-7816
• Leon Adrović — Klinička bolnica “Sveti Duh”, Zagreb, Hrvatska — ORCID: 0000-0002-0555-6863
• Jozica Šikić — Klinička bolnica “Sveti Duh”, Zagreb, Hrvatska — ORCID: 0000-0003-4488-0559

Abstract

**Introduction**: Hyperlipidemia is a major risk factor for coronary heart disease. Early treatment of hyperlipidemia following acute coronary syndrome (ACS) provides potential benefits. According to ESC Guidelines for the Management of Dyslipidaemias (1), it is recommended to initiate a high-dose statin therapy early after admission in all ACS patients, regardless of initial low-density lipoprotein cholesterol (LDL-C) values, with the aim of reaching the LDL-C goal < 1.8 mmol/L or at least a 50% reduction of LDL-C if the baseline is between 1.8 and 3.5 mmol/L. (1, 2) The latest results of EUROASPIRE V study showed that even though the majority of patients with ACS were receiving lipid-lowering therapy, only about one in three of these patients attained the recommended LDL-C goal values. The aim of this study was to investigate how many patients discharged with the diagnosis of ACS reach the recommended LDL-C goal values at 3-month follow-up. **Patients and Methods**: We retrospectively analyzed 206 patients discharged with a diagnosis of ACS: 90 patients (44%) had ST-segment elevation myocardial infarction, 86 (42%) had no ST-segment elevation myocardial infarction, and 30 (14%) had unstable angina pectoris. Among patients diagnosed with ACS, 66% were men and 34% were women, with a mean age of 66.13 years old. All patients received high-dose statin therapy (atorvastatin 80 mg or rosuvastatin 40 mg), a few of them even in combination with ezetimibe. We analyzed the baseline LDL-C values during hospital admission and after discharge at 3-month follow-up. **Results**: The average LDL-C value during hospital admission was 3.36 mmol/L, considering that 28% of patients already had some type of lipid-lowering therapy. At 3-month follow-up the average LDL-C value was 2.19 mmol/L. The target level of LDL-C < 1.8 mmol/L was attained by 38% of patients (**Figure 1**). FIGURE 1. Therapy effect on LDL-cholesterol reduction. LDL-C = LDL cholesterol. **Conclusion**: Only 38% of patients with ACS reached the LDL-C target at 3-month follow-up despite recommended therapy, which correlates with EUROASPIRE V findings. The poor goal attainment might be due to poor dietary habits and inadequate lifestyle. Therefore, we need to improve lipid management in ACS patients in secondary prevention.

Keywords

hyperlipidemia, acute coronary syndrome, low density lipoprotein cholesterol

DOI

Literature

1. Catapano AL, Graham I, De Backer G, Wiklund O, Chapman MJ, Drexel H, et al. 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias. Eur Heart J. 2016 Oct 14;37(39):2999–3058. https://doi.org/10.1093/eurheartj/ehw272
2. Balci B. The modification of serum lipids after acute coronary syndrome and importance in clinical practice. Curr Cardiol Rev. 2011 Nov;7(4):272–6. https://doi.org/10.2174/157340311799960690