Prospective evaluation of lipid management following acute coronary syndrome in non-Western countries

Ann Marie Navar, Simon T. Matskeplishvili, Miguel Urina-Triana, Mohammed Arafah, Jaw Wen Chen, Apichard Sukonthasarn, Valérie Corp dit Genti, Véronique Daclin, Eric D. Peterson

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Half the global burden of cardiovascular disease (CVD) is concentrated in the Asia-Pacific (APAC) region. Hypothesis: Suboptimal control of low-density lipoprotein cholesterol (LDL-C) may play a large role in the burden of CVD in APAC and non-Western countries. Methods: The Acute Coronary Syndrome Management (ACOSYM) registry is a multinational, multicenter, prospective observational registry designed to evaluate LDL-C control in patients within 6 months after hospitalization following an acute coronary syndrome (ACS) event across nine countries. Results: Overall, 1581 patients were enrolled, of whom 1567 patients met the eligibility criteria; 80.3% of the eligible patients were men, 46.1% had ST-elevation myocardial infarction, and 39.5% had non-ST-elevation myocardial infarction. Most (1245; 79.5%) patients were discharged on a high-intensity statin. During the follow-up, only 992 (63.3%) patients had at least one LDL-C measurement; of these, 52.9% had persistently elevated LDL-C (>70 mg/dl). The patients not discharged on a high-dose statin were more likely (OR 3.2; 95% CI 2.1–4.8) to have an LDL-C above the 70 mg/dl LDL-C target compared with those who were discharged on a high-dose statin. Conclusion: Our real-world registry found that a third or more of post-ACS patients did not have a repeat LDL-C follow-up measurement. In those with an LDL-C follow-up measurement, more than half (52.9%) were not achieving a <70 mg/dl LDL-C goal, despite a greater uptake of high-intensity statin therapy than has been observed in recent evidence. This demonstrates the opportunity to improve post-ACS lipid management in global community practice.

Original languageEnglish (US)
Pages (from-to)955-962
Number of pages8
JournalClinical Cardiology
Volume44
Issue number7
DOIs
StatePublished - Jul 2021
Externally publishedYes

Keywords

  • acute coronary syndrome
  • lipid management
  • low-density lipoprotein cholesterol
  • non-Western countries
  • statin therapy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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