Ulf Landmesser1, Angela Pirillo2, Michel Farnier3, J Wouter Jukema4, Ulrich Laufs5, François Mach6, Luis Masana7, Terje R Pedersen8, François Schiele9, Gabriel Steg10, Marco Tubaro11, Azfar Zaman12, Pepe Zamorano13, Alberico L Catapano14. 1. Department of Cardiology, Charité University Medicine Berlin, German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin Institute of Health (BIH), Berlin, Germany. 2. Center for the Study of Atherosclerosis, E. Bassini Hospital, Cinisello Balsamo, Milan, 3IRCCS MultiMedica, Sesto S. Giovanni, Milan, Italy. 3. Lipid Clinic, Point Médical and University Hospital Dijon-Bourgogne, Department of Cardiology, Dijon, France. 4. Dept of Cardiology, Leiden University Medical Center, Leiden, The Netherlands, Netherlands Heart Institute, Utrecht, the Netherlands. 5. Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Leipzig, 04103, Germany. 6. Cardiology Division, Geneva University Hospitals, Switzerland. 7. "Sant Joan" University Hospital, IISPV, CIBERDEM, Universitat Rovira I Virgili, Reus, Spain. 8. Oslo University Hospital, Ulleval and Medical Faculty, University of Oslo, Norway. 9. University Hospital Jean Minjoz, Department of Cardiology, Besançon, France, EA3920, University of Burgundy Franche-Comté, Besançon, France. 10. French Alliance for Cardiovascular Trials, Université de Paris, Assistance Publique-Hôpitaux de Paris, INSERM U1148, Paris, France. 11. Head of ICCU-Division of Cardiology, San Filippo Neri Hospital, Rome, Italy. 12. Freeman Hospital and Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, UK. 13. University Hospital Ramon Y Cajal, Madrid, Spain. 14. Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, IRCCS MultiMedica, Sesto S. Giovanni, Milan, Italy. Electronic address: alberico.catapano@unimi.it.
Abstract
BACKGROUND AND AIMS: Post-acute coronary syndrome (ACS) patients are at very high risk for recurrent events and mortality, despite the availability of effective pharmacological approaches. Aim of this survey was to evaluate the compliance to ESC/EAS guidelines during the management of ACS patients and the effectiveness of secondary prevention in seven European countries. METHODS: By means of an online questionnaire, data on 2775 ACS patients (either acute case or follow-up patients) were collected, including data on lipid profile, medications, follow-up visit planning, screening for familial hypercholesterolemia. RESULTS: Lipid profiles were obtained for 91% of ACS patients in the acute phase, mostly within the first day of hospitalization (73%). During hospitalization, 93% of the patients received a lipid-lowering treatment; at discharge, only 66% of the patients received a high intensity statin therapy. At the first follow-up, most of the patients (77.6%) had LDL-C >70 mg/dL; among them, 41% had no change in their lipid-lowering therapies. Similar data were obtained during the second follow-up visit. The analysis of a subgroup of patients with at least 2 follow-up visits and known LDL-C levels showed that the percentage of patients at goal increased from 9% to 32%, and patients with LDL-C <100 mg/dL raised from 23% to 72%. Among acute cases, 44 were admitted with a diagnosis of familial hypercholesterolemia (FH); only 18% of the remaining patients were screened for FH. CONCLUSIONS: Contemporary lipid management of very high CV risk patients is sub-optimal despite available treatments. Greater efforts are warranted to optimize cardiovascular prevention.
BACKGROUND AND AIMS: Post-acute coronary syndrome (ACS) patients are at very high risk for recurrent events and mortality, despite the availability of effective pharmacological approaches. Aim of this survey was to evaluate the compliance to ESC/EAS guidelines during the management of ACS patients and the effectiveness of secondary prevention in seven European countries. METHODS: By means of an online questionnaire, data on 2775 ACS patients (either acute case or follow-up patients) were collected, including data on lipid profile, medications, follow-up visit planning, screening for familial hypercholesterolemia. RESULTS:Lipid profiles were obtained for 91% of ACS patients in the acute phase, mostly within the first day of hospitalization (73%). During hospitalization, 93% of the patients received a lipid-lowering treatment; at discharge, only 66% of the patients received a high intensity statin therapy. At the first follow-up, most of the patients (77.6%) had LDL-C >70 mg/dL; among them, 41% had no change in their lipid-lowering therapies. Similar data were obtained during the second follow-up visit. The analysis of a subgroup of patients with at least 2 follow-up visits and known LDL-C levels showed that the percentage of patients at goal increased from 9% to 32%, and patients with LDL-C <100 mg/dL raised from 23% to 72%. Among acute cases, 44 were admitted with a diagnosis of familial hypercholesterolemia (FH); only 18% of the remaining patients were screened for FH. CONCLUSIONS: Contemporary lipid management of very high CV risk patients is sub-optimal despite available treatments. Greater efforts are warranted to optimize cardiovascular prevention.
Authors: Vivencio Barrios; Mar Castellanos; Raquel Campuzano Ruiz; Jorge Francisco Gómez Cerezo; Isabel Egocheaga Cabello; José M Gámez; Icíar Martínez López; José María Mostaza; Nuria Morant Talamante; Javier Parrondo; Aram Sicras Navarro; Inés Pérez Román; Antoni Sicras-Mainar; Vicente Pallarés-Carratalá Journal: Front Cardiovasc Med Date: 2022-08-04