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LDL-Cholesterol levels after Acute Coronary Syndrome: 24-months variations and impact on outcomes
Session:
Posters (Sessão 3 - Écran 5) - Risco Cardiovascular 1 - Lípidos e Hipertensão Arterial
Speaker:
André Dias de Frias
Congress:
CPC 2022
Topic:
J. Preventive Cardiology
Theme:
28. Risk Factors and Prevention
Subtheme:
28.4 Lipids
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Dias de Frias; Cristine Schmidt; Mauro Moreira; Preza Fernandes; Sandra Magalhães; Mário Santos; Severo Torres
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u><span style="color:black">Introduction</span></u><span style="color:black">: Patients with acute coronary syndrome (ACS) are at very high risk of recurrent cardiovascular (CV) events. Despite the evidence supporting an immediate and intensive lowering of LDL-cholesterol (LDL-C), most of the real-world studies are focus on short-term outcomes.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u><span style="color:black">Aim</span></u><span style="color:black">: To assess LDL-C levels during the first 24 months post-ACS.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u><span style="color:black">Methods</span></u><span style="color:black">: Single-center, retrospective observational study that included all consecutive post-ACS patients enrolled in a phase 2 cardiac rehabilitation (CR) program in 2017. For this study, patients were divided into two groups according to ESC 2016 guidelines on dyslipidemia. Group 1 (n=111): patients with LDL-C <70 mg/dl levels at 3 months post-ACS, and group 2 (n=87): patients with LDL-C>70 mg/dl.</span> </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u><span style="color:black">Results</span></u><span style="color:black">: Of the 198 patients studied, 82% were male, with a mean age 60.3±10.7 years old and baseline mean LDL-C 98.6±34.6 mg/dl. The two groups were comparable in comorbidities, ACS presentation, revascularization strategy, LDL-C medication, and CR adherence. Group 1 had lower LDL-C baseline values (89.3±31.8 mg/dl vs. 112.9±33.6 mg/dl, <em>p </em><0.001) and higher reduction of LDL-C at 3 months (-37.8±33.7 vs. -22.5±46.7mg/dl, <em>p</em>=0.009). At 12 months, although mean LDL-C in group 1 increased 10.1mg/dl (</span><span style="color:black">95%IC: 1.8 to 13.6 </span><span style="color:black">vs. 3 months levels), the mean LDL-C remained in optimal values (61.8±19 mg/dl). Conversely, group 2 trended to an LDL reduction of 5.3mg/dl (</span><span style="color:black">95%IC: 2.2 to -13.2, p=0.158)</span><span style="color:black">, but the mean LDL-C continued high (85.8±32.6 mg/dl), with 69% of patients still above the LDL threshold of 70 mg/dL vs 30% in group 1. At 24 months, both groups showing similar suboptimal LDL-C levels (71±25.6 vs. 73.7±26.6 mg/dl, <em>p=</em>0.523). </span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">Conclusions: The proportion of post-ACS patients with uncontrolled LDL-C levels is significant and increase over time. Demographic and clinical profile do not explain differences in LDL control. Further studies are needed to understand the causes and implement effective strategies in this high-risk subgroup of patients.</span></span></span></p>
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