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Patients with Acute Coronary Syndrome are at High Risk Prior to the Event and Lipid Management is Underachieved Pre- and Post- Hospitalization

[ Vol. 16 , Issue. 4 ]

Author(s):

C. Vlachopoulos*, G. Andrikopoulos, D. Terentes-Printzios, S. Tzeis, E. K. Iliodromitis, D. Richter, I. Mantas, A. Kartalis, V. Vasilikos, D. Stakos, S. Patsilinakos, S. Lampropoulos, D. Symeonidis, C. Kyrpizidis, N. Marinakis, N. Nikas, J. Lekakis, D. Tousoulis and P. Vardas   Pages 405 - 413 ( 9 )

Abstract:


Background: Current European Guidelines suggest the use of cardiovascular risk categories and also recommend using high-intensity statins for patients with acute coronary syndromes (ACS).

Objective: We examined the risk of ACS patients prior to the event, as well as the overall use and intensity of statins.

Methods: We enrolled 687 ACS patients (mean age 63 years, 78% males). Low-density lipoprotein cholesterol (LDL-C) levels upon admission were used to assess attainment of LDL-C targets. Patients were categorized as very high, high, moderate and low risk based on their prior to admission cardiovascular (CV) risk. We examined statin use and dosage intensity among patients discharged from the hospital. Patients were followed for a median period of 189 days.

Results: The majority of the patients (n=371, 54%) were at very high CV risk prior to admission, while 101 patients were at high risk (15%), 147 (21%) moderate risk and 68 (10%) low risk. Interestingly, LDL-C target attainment decreased as the risk increased (p<0.001). The majority (96%) of patients received statins at discharge; however, most of them (60.4%) received low/moderate intensity statins and just 35.9% received the suggested by the Guidelines high-intensity dose of statins. At follow-up, the rate of patients at high-intensity dose of statins remained similar (34.8%); 6% received no statins at all at follow-up.

Conclusion: According to our study, the majority of ACS patients are already at high risk prior to their admission. Further, LDL-C targets are underachieved prior to the event and high-intensity statins are underutilized in ACS patients at, and post-discharge.

Keywords:

Cardiovascular risk, acute coronary syndrome, statins, LDL, intensity, target.

Affiliation:

1st Cardiology Department, Hippokration Hospital, Athens Medical School, Athens, Henry Dunant Hospital, Athens, 1st Cardiology Department, Hippokration Hospital, Athens Medical School, Athens, Henry Dunant Hospital, Athens, Athens Medical School, Attikon University Hospital, Athens, Second Department of Cardiology, Athens Euroclinic, General Hospital of Chalkida, Chalkida, Skylitsion General Hospital of Chios, Chios, First Department of Cardiology, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Cardiology Department, Democritus University of Thrace, Alexandroupolis, Department of Cardiology, Konstantopoulio General Hospital, Athens, Bodosakeio General Hospital of Ptolemaida, Ptolemaida, Cardiology Department, General Hospital of Kavala, Kavala, Department of Cardiology, 2nd IKA Hospital, Thessaloniki, Department of Cardiology, Sotiria Chest Diseases Hospital, Athens, AstraZeneca SA, Medical Department, Athens, Athens Medical School, Attikon University Hospital, Athens, 1st Cardiology Department, Hippokration Hospital, Athens Medical School, Athens, Department of Cardiology, Heraklion University Hospital, Crete

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