Impact of Adherence to Lipid-Lowering Guidelines on the Achievement of Lipid Profile Goals in Patients With Acute Coronary Syndrome: A Prospective Cohort Study

Acute coronary syndrome (ACS) is one of the main causes of mortality worldwide, and dyslipidemia is one of its important risk factors. Studies have shown that treatment with high-intensity statins protects against cardiovascular events; other investigations have noted that despite the potential effects of statins, 80% of patients with ACS fail to lower cholesterol levels. We conducted the present study to determine the association between medical compliance to clinical practice guidelines (CPG) and changes in low-density lipoprotein cholesterol (LDL-C) at follow-up among patients with ACS.
 
We performed a prospective cohort study on patients diagnosed with ACS. We enrolled 79 adult patients from August 2019 through March 2020. Data on patient characteristics at presentation, hospitalization, and 8 months of follow-up were collected. Adherence was established as a high-intensity statin prescription at discharge according to Peruvian, European Society of Cardiology (ESC) 2019, and American Heart Association (AHA) 2018 guidelines.
 
Adherence to AHA and ESC guidelines showed a reduction in mean LDL-C values of 44.2 mg/dL (P = 0.14). In patients with dyslipidemia, mean LDL-C values were reduced by 60.6 mg/dL (P < 0.001). Only 27.8% of the patients did not achieve any goal in their LDL-C levels following the AHA or ESC guideline recommendations.
 
Due to the high prevalence of dyslipidemia, adequate primary prevention before an acute event occurs is essential. Compliance with CPG by healthcare personnel is related to a reduction in LDL-C levels at follow-up, and patient adherence is essential to achieve LDL-C targets. (Iranian Heart Journal 2023; 24(4): 54-62)