Achievement of target LDL-cholesterol level in patients with acute coronary syndrome undergoing percutaneous coronary intervention: The JET-LDL registry. in International journal of cardiology / Int J Cardiol. 2024 Feb 15;397:131659. doi: 10.1016/j.ijcard.2023.131659. Epub 2023 Dec 14.

2024
ASL Biella
ASL Vercelli
ASL Torino 4
AOU Novara
ASL Torino 3
AOU San Luigi di Orbassano
AO Ordine Mauriziano

Tipo pubblicazione

Journal Article

Autori/Collaboratori (25)Vedi tutti...

Varbella F
SC Cardiologia, Ospedale di Rivoli, Italy.
Delnevo F
Cardiologia, Azienda Ospedaliera Ordine Mauriziano, Torino, Italy.
Solli M
Università del Piemonte Orientale, Cardiologia, AOU Maggiore della Carità di Novara, Italy.

et alii...

Abstract

BACKGROUND: In patients with acute coronary syndromes (ACS), current guidelines recommend a low-density lipoprotein cholesterol (LDL-C) level < 1.4 mmol/L (<55 mg/dL). METHODS: The JET-LDL is a multicenter, observational, prospective registry created to investigate levels of LDL-C in consecutive patients with ACS undergoing PCI at 35 Italian hospitals, and to report their lipid lowering therapies (LLT). Follow-up was planned at 1 and 3 months. LDL-C reduction >50% from baseline or level < 55 mg/dL at 1-month was the primary endpoint. RESULTS: A total of 1095 patients were included: median age was 67 (58-75); 33.7% were already on LLT. Baseline LDL-C levels was 105 (76.5-137) mg/dL. At hospital discharge all patients were on LLT: 98.1% received statins (as mono or combination therapy), ezetimibe and PCSK9i were used in 60.1% and 8.5% of cases, respectively. Primary endpoint was achieved in 62% (95% CI 58-65) of cases. At 1-month LDL-C levels dropped to 53 (38-70) mg/dL (p < 0.001 vs baseline) and it was <55 mg/dL in 53% (95% CI 49-57) of patients; however, PCSK9i were added to 7 further cases. At 3-months 58% (95% CI 55-62) of patients achieved the target level, but PCSK9i was added to only 11 new patients. CONCLUSIONS: In this real-world registry of ACS patients undergoing PCI, recommend LDL-C levels were obtained in 62% of patients, but PCSK9i prescription was limited to 10% of cases. As LLT pattern appeared mainly improved at hospital discharge, an early and strong treatment should be considered.

Accesso banca dati bibliografica

PMID : 38101704

DOI : 10.1016/j.ijcard.2023.131659

Keywords

PCI; Lipids; Guidelines; Cholesterol; Acute coronary syndromes; Observational Studies as Topic; Multicenter Studies as Topic; Middle Aged; Treatment Outcome; Registries; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use; Percutaneous Coronary Intervention; Cholesterol, LDL; Anticholesteremic Agents/therapeutic use; Acute Coronary Syndrome/diagnosis/drug therapy/surgery; Humans; Aged;