Failure to achieve LDL-C and HS-CRP targets in post-acute myocardial infarction patients: prevalence and predictors.

BACKGROUND

Residual cardiovascular risk after acute myocardial infarction (AMI) is driven not only by dyslipidemia but also by systemic inflammation. High-sensitivity C-reactive protein (hs-CRP) and low-density lipoprotein cholesterol (LDL-C) represent two independent and complementary biomarkers of risk. Achieving dual therapeutic targets for both markers has been shown to improve outcomes, yet data in Southeast Asian populations remain scarce.

OBJECTIVES

This study investigated the prevalence and predictors of failure to achieve hs-CRP and LDL-C targets in post-AMI patients in Vietnam.

METHODS

A descriptive cross-sectional study was conducted on 93 patients with prior AMI at Tam Duc Heart Hospital between September 2024 and June 2025. Demographic, clinical, and laboratory parameters were collected. hs-CRP and LDL-C levels were measured, and target achievement rates were assessed. Logistic regression analyses were performed to identify independent predictors.

RESULTS

Among 93 patients (mean age 66.1 ± 10.1 years, 76.3% male), 24.7% had hs-CRP ≥ 2 mg/L and 43.0% failed to achieve LDL-C < 70 mg/dL. Overall, 51.6% of patients failed to reach at least one target, with 16.1% failing both. Chronic kidney disease, sacubitril/valsartan use, and LDL-C ≥ 70 mg/dL were associated with failure to achieve hs-CRP targets. Diabetes mellitus and elevated hs-CRP were associated with LDL-C non-attainment. Use of ACEI/ARB therapy was identified as a protective factor against dual target failure.

CONCLUSIONS

A substantial proportion of Vietnamese post-AMI patients fail to achieve dual hs-CRP and LDL-C targets, with diabetes and chronic kidney disease contributing to residual risk. These findings underscore the need for intensified secondary prevention strategies addressing both lipid and inflammatory pathways.