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

Abstract

Background: 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. Methods: 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. Results: 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. Conclusions: 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.