Risk Factors Associated with Failure to Achieve the Low Density Lipoprotein Cholesterol Therapeutic Target in Patients with Acute Coronary Syndrome: A Longitudinal, Single Centre Investigation.

INTRODUCTION: Reducing low-density lipoprotein cholesterol (LDL-C) to target < 100 mg/dL is considered as a critical therapeutic goal after acute coronary syndrome (ACS).

AIM: To evaluate the factors associated with reaching or not this LDL-C target after 6 months of statin therapy.

METHODS: Demographic features and other clinically relevant information from a cohort of patients enrolled from April 3, 2016 through March 20, 2017 were analyzed in the current investigation. All included cases had baseline LDL-C levels ≥ 100 mg/dL. LDL-C levels were determined once again after 6-month of statin therapy for each patient.

RESULTS: Two hundred and thirty two participants were included in the final analysis. One third of patients (33.2%) with ACS with initially elevated LDL-C failed to attain LDL-C goal at 6 months. Spearman correlation test showed that the age, diabetes mellitus, lipid lowering therapy and statin daily dose were among the influential factors associated with LDL-C goal achievement. Furthermore, multiple logistic regression analysis revealed that diabetes mellitus and statin treatment before admission were the only independent predictors of achieving LDL-C goal.

CONCLUSIONS: According to our findings, the drug adherence and use of higher intensity as recommended in secondary prevention are needed to increase the achievement of LDL-C treatment targets.