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
2021 Clinical Cardiology  
Half the global burden of cardiovascular disease (CVD) is concentrated in the Asia-Pacific (APAC) region. 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. 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
more » ... S) event across nine countries. 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. 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.
doi:10.1002/clc.23623 pmid:34089263 fatcat:tdaevy2u4nbalcmmedundeorca