Authors

• Tomislav Čikara — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0001-8012-4481
• Irzal Hadžibegović — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0002-3768-9134
• Miroslav Raguž — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0003-1567-8503
• Marin Pavlov — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0003-3962-2774
• Nikola Pavlović — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0001-9187-7681
• Petra Vitlov — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0001-6983-1409
• Petar Lišnjić — University of Zagreb School of Medicine, Zagreb, Croatia — ORCID: 0009-0003-7890-6531
• Šime Manola — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0001-6444-2674
• Ivana Jurin — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0002-2637-9691

Abstract

**Introduction**: There are many trials who have demonstrated that lower low-density lipoprotein-cholesterol (LDL-C) levels after acute coronary syndrome (ACS) are associated with lower cardiovascular event rates (1). The current guidelines for secondary prevention recommend lowering LDL-C to 2) | 28.9±4.9 | 29.1±4.4 | 29.0±4.6 | | Medical history Hypertension, n (%) Diabetes, n (%) Coronary artery disease, n (%) Peripheral artery disease, n (%) | 512 (75.6%) 167 (25.7%) 111 (16.4%) 60 (8.9%) | 991 (74.2%) 310 (23.2%) 196 (14.7%) 185 (13.9%) | 1503 (74.7%) 477 (23.7%) 307 (15.3%) 245 (12.2%) | | ACS type STEMI NSTEMI UAP | 384 (56.7%) 288 (42.5%) 5 (0.7%) | 724 (54.2%) 596 (44.6%) 15 (1.1%) | 1108 (55.1%) 884 (43.9%) 20 (1.5%) | [†] ACS = acute coronary syndrome; STEMI = acute ST-elevation myocardial infarction; NSTEMI = non-ST-elevation myocardial infarction; UAP = unstable angina pectoris **Conclusion**: Our analysis shows that lipid-lowering treatment is suboptimal and needs significant improvement. Earlier control visits with therapeutic interventions should be performed. Also, earlier high intensity statin combination therapy should be encouraged.

Keywords

acute coronary syndrome, dyslipidemia, therapeutic inertia, treatment goals

DOI

Literature

1. Ference BA, Ginsberg HN, Graham I, Ray KK, Packard CJ, Bruckert E, et al. Low-density lipoproteins cause atherosclerotic cardiovascular disease. 1. Evidence from genetic, epidemiologic, and clinical studies. A consensus statement from the European Atherosclerosis Society Consensus Panel. Eur Heart J. 2017 August 21;38(32):2459–72. https://doi.org/10.1093/eurheartj/ehx144
2. Byrne RA, Rossello X, Coughlan JJ, Barbato E, Berry C, Chieffo A, et al. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J. 2023 October 12;44(38):3720–826. https://doi.org/10.1093/eurheartj/ehad191