Background and aims: Ischemic heart diseases are the main cause of death worldwide, therefore secondary prevention and treatment of coronary artery disease (CAD) are highly significant for public health and mortality. The objective of this study is to evaluate LDL cholesterol (LDL-C) levels as outcomes of secondary prevention of CAD in Finland up to 24 months after being diagnosed with acute coronary syndrome (ACS). This retrospective analysis of patients with ACS was conducted in two areas of Finland that have a combined population of 400,000.
Methods: The data used in the study covered all outpatient visits, inpatient episodes, prescriptions and LDL-C results for ACS patients during 2011-2015. To evaluate the outcome of the prevention, three separate measurements of patients' LDL-C levels were considered: baseline, first follow-up and final follow-up. The factors associated with reaching treatment goal were identified using logistic regression analysis.
Results: 32% of ACS patients achieved the treatment goal (LDL-C <1.8 mmol/l) at the end of the 24-month follow-up period, but 21% of patients fluctuated between being on and above target.
Conclusion: Two thirds of CAD patients with ACS and on statin therapy do not achieve LDL-C treatment target recommended by the guidelines. Since LDL-C levels fluctuate in the follow-up, a low level during the first 12 months after the acute event does not guarantee the maintenance of the results in the long term. Hence, LDL-C levels should be monitored at least on an yearly basis on follow-ups, and treatment adapted accordingly.
Keywords: Acute coronary syndrome; Coronary artery disease; Longitudinal studies; Secondary prevention.
Copyright © 2020 Elsevier B.V. All rights reserved.
Conflict of interest statement
Declaration of competing interest The study was partly funded by Amgen Ltd., who provided funds for the work of RL, AT, MN and FH and covered the cost of data retrieval. TL has received a small consulting fee from Amgen in 2014 for providing expertise in defining the data collection criteria and organizing data collection in North Karelia. The supporting source had no involvement in the conduct of the study or access to the data. The authors had full access to the study data.
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