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Background <p>Atherosclerotic cardiovascular disease (ASCVD) remains a major cause of morbidity and mortality, with dyslipidemia representing a key modifiable risk factor in secondary prevention. Despite clear guideline recommendations, real‑world lipid‑lowering therapy (LLT) use and LDL‑C target attainment remain suboptimal in many regions. This study evaluated LLT prescribing patterns and LDL‑C reduction among patients admitted with acute coronary syndrome (ACS) or undergoing percutaneous coronary intervention (PCI) for chronic coronary disease (CCD) in a tertiary care center.</p> Methods <p>This retrospective observational study included adult patients hospitalized between June 2020 and June 2024 for ACS or elective PCI for CCD. Electronic medical records were screened by independent chart review. Demographics, cardiovascular risk factors, LLT prescriptions, and lipid profiles at baseline and 6 (± 3) months were collected. LLT regimens and the reduction in LDL were analyzed. Non-normally distributed continuous variables were analyzed using non‑parametric methods Wilcoxon Signed Ranks Test and Kruskal–Wallis test, while categorical variables were evaluated using Chi-Square test.</p> Results <p>Of 363 screened patients, 314 met inclusion criteria, and 98 had follow‑up lipid measurements at 6 (± 3) months. Statin monotherapy was prescribed in 81.5% of patients at discharge, while 12.4% received combination therapy. High‑intensity statins were predominantly used, although some patients received only moderate‑intensity therapy. Prior statin exposure significantly influenced discharge prescribing patterns (<i>p</i> &lt; 0.001). Significant LDL‑C reductions were observed at 6 (± 3) months among patients with and without prior LLT (<i>p</i> &lt; 0.001). Overall, 47.95% achieved LDL‑C target of &lt; 70&#xa0;mg/dL, others needed improvements in their adherence and therapy optimization.</p> Conclusion <p>In the patient cohort studied, prescribing pattern were largely consistent with guideline recommended statin therapy. Although all treatment groups achieved significant reductions in the LDL‑C levels, a proportion of patients remained above guideline‑recommended targets, reflecting need for exploring additional strategies to optimize lipid control. Continued follow‑up and broader implementation of guideline‑directed LLT intensification are warranted to improve LDL‑C control in post‑ACS and post‑PCI CCD populations.</p> Trial registration <p>Not applicable. </p>

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Statin intensity, prescribing patterns, and LDL‑C reduction following ACS and in CCD patients who underwent PCI in a tertiary care setting

  • 期刊论文

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  • 发表日期：

    2026年5月5日

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  • Sara Abdelrady,
  • Seeba Zachariah,
  • Sony Mathew,
  • Karim Ghannem

摘要

Background

Atherosclerotic cardiovascular disease (ASCVD) remains a major cause of morbidity and mortality, with dyslipidemia representing a key modifiable risk factor in secondary prevention. Despite clear guideline recommendations, real‑world lipid‑lowering therapy (LLT) use and LDL‑C target attainment remain suboptimal in many regions. This study evaluated LLT prescribing patterns and LDL‑C reduction among patients admitted with acute coronary syndrome (ACS) or undergoing percutaneous coronary intervention (PCI) for chronic coronary disease (CCD) in a tertiary care center.

Methods

This retrospective observational study included adult patients hospitalized between June 2020 and June 2024 for ACS or elective PCI for CCD. Electronic medical records were screened by independent chart review. Demographics, cardiovascular risk factors, LLT prescriptions, and lipid profiles at baseline and 6 (± 3) months were collected. LLT regimens and the reduction in LDL were analyzed. Non-normally distributed continuous variables were analyzed using non‑parametric methods Wilcoxon Signed Ranks Test and Kruskal–Wallis test, while categorical variables were evaluated using Chi-Square test.

Results

Of 363 screened patients, 314 met inclusion criteria, and 98 had follow‑up lipid measurements at 6 (± 3) months. Statin monotherapy was prescribed in 81.5% of patients at discharge, while 12.4% received combination therapy. High‑intensity statins were predominantly used, although some patients received only moderate‑intensity therapy. Prior statin exposure significantly influenced discharge prescribing patterns (p < 0.001). Significant LDL‑C reductions were observed at 6 (± 3) months among patients with and without prior LLT (p < 0.001). Overall, 47.95% achieved LDL‑C target of < 70 mg/dL, others needed improvements in their adherence and therapy optimization.

Conclusion

In the patient cohort studied, prescribing pattern were largely consistent with guideline recommended statin therapy. Although all treatment groups achieved significant reductions in the LDL‑C levels, a proportion of patients remained above guideline‑recommended targets, reflecting need for exploring additional strategies to optimize lipid control. Continued follow‑up and broader implementation of guideline‑directed LLT intensification are warranted to improve LDL‑C control in post‑ACS and post‑PCI CCD populations.

Trial registration

Not applicable.