Atherosclerosis plus · 2026
Lipoprotein(a) and early LDL-cholesterol target attainment after a first acute coronary syndrome: a real-world cohort study.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Riera-Molist Núria, Puigoriol Juvanteny Emma, Swedzky Federico, Goutan-Roura Ester, Fassano Nicolás José, Montserrat Ortego Sílvia, Miarons Marta
Аннотация
BACKGROUND: Despite intensive lipid-lowering therapy, early attainment of the guideline-recommended LDL-cholesterol (LDL-C) target after acute coronary syndrome (ACS) remains suboptimal. Baseline factors associated with early LDL-C target attainment remain incompletely characterized, particularly the role of lipoprotein(a) [Lp(a)]. We aimed to assess early LDL-C target attainment after a first ACS and identify baseline factors associated with target attainment, with a particular focus on Lp(a).
METHODS: We conducted a retrospective cohort study of consecutive hospitalized adults with a first ACS undergoing percutaneous coronary intervention between January 2025 and April 2026. The primary endpoint was attainment of the guideline-recommended LDL-C target at early follow-up, defined as LDL-C < 55 mg/dL and a ≥ 50% reduction from baseline. Associations between clinical variables and LDL-C target attainment were assessed using multivariable logistic regression.
RESULTS: Eighty-two patients were included; 70.7% were male and 37.2% had elevated Lp(a) levels. At a median follow-up of 5 weeks (IQR, 4-6), 31.7% attained the LDL-C target despite prescription of high-intensity statin therapy at discharge. In the multivariable model, low Lp(a) (OR 8.72; 95% CI 2.04-37.33), current smoking (OR 5.29; 95% CI 1.42-19.69), and ezetimibe use in addition to high-intensity statin therapy at discharge (OR 5.28; 95% CI 1.31-21.32) were associated with LDL-C target attainment.
CONCLUSIONS: Early LDL-C target attainment after a first ACS remained limited despite routine prescription of high-intensity statin therapy. Elevated Lp(a) was associated with a lower likelihood of attaining the LDL-C target. Prospective studies are needed to confirm these findings.
METHODS: We conducted a retrospective cohort study of consecutive hospitalized adults with a first ACS undergoing percutaneous coronary intervention between January 2025 and April 2026. The primary endpoint was attainment of the guideline-recommended LDL-C target at early follow-up, defined as LDL-C < 55 mg/dL and a ≥ 50% reduction from baseline. Associations between clinical variables and LDL-C target attainment were assessed using multivariable logistic regression.
RESULTS: Eighty-two patients were included; 70.7% were male and 37.2% had elevated Lp(a) levels. At a median follow-up of 5 weeks (IQR, 4-6), 31.7% attained the LDL-C target despite prescription of high-intensity statin therapy at discharge. In the multivariable model, low Lp(a) (OR 8.72; 95% CI 2.04-37.33), current smoking (OR 5.29; 95% CI 1.42-19.69), and ezetimibe use in addition to high-intensity statin therapy at discharge (OR 5.28; 95% CI 1.31-21.32) were associated with LDL-C target attainment.
CONCLUSIONS: Early LDL-C target attainment after a first ACS remained limited despite routine prescription of high-intensity statin therapy. Elevated Lp(a) was associated with a lower likelihood of attaining the LDL-C target. Prospective studies are needed to confirm these findings.