Outcomes of lipid control in secondary prevention of coronary artery disease in Finland: A 24-month follow-up after acute coronary syndrome

Atherosclerosis. 2020 Mar:296:4-10. doi: 10.1016/j.atherosclerosis.2020.01.018. Epub 2020 Jan 21.


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.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Coronary Syndrome / blood*
  • Acute Coronary Syndrome / therapy
  • Aftercare
  • Aged
  • Aged, 80 and over
  • Cholesterol, LDL / blood*
  • Comorbidity
  • Coronary Artery Disease / blood
  • Coronary Artery Disease / prevention & control*
  • Diabetes Mellitus / epidemiology
  • Female
  • Finland
  • Follow-Up Studies
  • Goals
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Hypertension / epidemiology
  • Male
  • Retrospective Studies
  • Secondary Prevention
  • Treatment Outcome


  • Cholesterol, LDL
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors