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07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
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32. Cardiovascular Nursing
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New values of low-density lipoprotein cholesterol in acute coronary syndrome-are we far from them?
Session:
Painel 12 - Prevenção / Reabilitação Cardíaca3
Speaker:
Lisa Maria Ferraz
Congress:
CPC 2020
Topic:
J. Preventive Cardiology
Theme:
28. Risk Factors and Prevention
Subtheme:
28.4 Lipids
Session Type:
Posters
FP Number:
---
Authors:
Lisa Maria Ferraz; Cátia Quina; Diana Vale Carvalho; Pedro Teixeira Carvalho; Raquel Ferreira; Ana Faustino; Ana Maria Briosa Neves
Abstract
<p><strong>Introduction:</strong> Several studies have shown a linear relationship between low-density lipoprotein cholesterol (LDL-C) values and atherosclerotic cardiovascular disease. All individuals with a history of acute coronary syndrome (ACS) should receive intensive statin therapy in order to achieve the desirable LDL-C values recently modified in the guidelines of the European Society of Cardiology.</p> <p><strong>Purpose:</strong> To evaluate the lipid profile control of ACS patients with 6 year follow-up.</p> <p><strong>Methods:</strong> Retrospective study of 138 consecutive patients (P) admitted in our hospital for ACS during one year: 76.8% male, 63 ± 13 years, 26.9% with history of coronary artery disease and 56.5% of dyslipidemia. A 6 year follow-up was performed and a therapeutic goal was defined as LDL-C values below 55mg/dL and an LDL-C reduction of ≥50% from baseline, according to the guidelines of the European Society of Cardiology. High/moderate/low intensity statins were defined according to the therapeutic recommendations of the American College of Cardiology. Univariate analysis was performed.</p> <p><strong>Results:</strong> The mean LDL-C value at ACS admission was 112.5 ± 36.9mg/dL. 96.4% of patients were discharged on statins: 41.3% with rosuvastatin 10mg, 15.2% with simvastatin 20mg, 15.2% with atorvastatin 10mg, 10.9% with pitavastatin 2mg and 6.5% with atorvastatin 20mg. The least prescribed statins were simvastatin 40mg (n=4), simvastatin 10mg (n=2), atorvastatin 40mg (n=2), pitavastatin 1mg (n=2), rosuvastatin 20mg (n=1) and fluvastatin 80mg (n=1). Antidislipidemic therapy was changed in 7.9% of patients in the scheduled evaluation 1 month after discharge: in 3.1% of patients there was a change in dose, 3.9% in class and in 0.9% in both; after that, most P (92.1%) remained with the prescribed statin. The mean LDL-C value after a 6 year follow-up was 83.6 ± 27.2mg/dL, with 85.8% P not meeting the defined therapeutic goal. Most of them (97.5%) continued medicated with statin, however, only 28.3% of P were on high-intensity statins and 3.8% were on low-intensity statins, despite the verified statistically significant association between LDL-C values and statin type used (high/medium/low intensity, p<0.05).</p> <p><strong>Conclusion: </strong>Despite the proven benefit of statins, especially in high-risk patients, there are still aspects to improve, notably in the establishment of more effective therapies in order to achieve the desired new goals.</p>
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