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Long-term Lipid Target Achievement After Acute Myocardial Infarction and Ischemic Stroke: A Real-World Analysis
Session:
SESSÃO DE POSTERS 36 - TUDO SOBRE LÍPIDOS
Speaker:
Dra Anabela Raimundo
Congress:
CPC 2025
Topic:
J. Preventive Cardiology
Theme:
28. Risk Factors and Prevention
Subtheme:
28.4 Lipids
Session Type:
Cartazes
FP Number:
---
Authors:
Anabela Raimundo; Helder Dores; Joana Costa; Bernardo Neves
Abstract
<p><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">Background: Despite clear guidelines for lipid management after acute cardiovascular events, real-world achievement of he recommended targets remains elusive. Contemporary European Society of Cardiology (ESC) guidelines set ambitious lipid goals, particularly for LDL-cholesterol, yet their attainment in clinical practice is poorly characterized. </span></span></p> <p><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">Aim: To evaluate the achievement of ESC recommended lipid targets in patients after acute myocardial infarction and ischemic stroke.</span></span></p> <p><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">Methods: In a single-center retrospective study, we analyzed lipid control in 966 consecutive patients following acute myocardial infarction (58.0%) or ischemic stroke (42.0%). The cohort (65.6% male, median age 71.0 years [IQR: 21.8]) was followed for up to 5 years. Electronic health records were scrutinized for lipid measurements, evaluating achievement of guideline targets: LDL-C <55 mg/dL, non-HDL-C <85 mg/dL, triglycerides <150 mg/dL, and HDL-C >40/50 mg/dL for males/females. </span></span></p> <p><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">Results: Initial LDL-C target achievement at baseline was remarkably low at 10.0% (32/319), improving to 25.1% (48/191) at 6 months and reaching its peak at 27.9% (79/283) at 1 year. Subsequently, target achievement declined: 22.4% (35/156) at 2 years, 19.1% (22/115) at 3 years, 18.0% (20/111) at 4 years, and 21.0% (17/81) at 5 years. In contrast, triglyceride targets were consistently achieved by most patients, ranging from 76.8% (235/306) initially to 80.5% (66/82) at 5 years. While HDL-C levels showed achievement rates between 53.6% (187/349) and 64.0% (57/89) throughout follow-up. </span></span></p> <p><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">Conclusions: Our findings reveal a striking gap between guideline recommendations and reaching real-world LDL-C targets after major cardiovascular events. The transient peak in reaching target LDL-C at one year, followed by declining success rates, suggests that maintaining long-term lipid control remains a very significant challenge in clinical practice. These results underscore the urgent need for more effective strategies to optimize lipid management in high-risk cardiovascular patients.</span></span></p>
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