ISSN: 0034-8376
eISSN: 2564-8896






Evaluation of Low-density Lipoprotein Cholesterol Target Attainment Rates According to the 2016 and 2019 European Society of Cardiology/ European Atherosclerosis Society Dyslipidemia Guidelines for Secondary Prevention in Patients with Acute Myocardial Infarction



Barış Şimşek, Department of Cardiology, Health Sciences University, Dr. Siyami Ersek Training and Research Hospital, Istanbul, Turkey
Duygu İnan, Başakşehir Çam and Sakura Training and Research Hospital, Istanbul, Turkey
Tufan Çınar, Health Sciences University, Sultan II, Abdülhamid Han Training and Research Hospital, Istanbul, Turkey
Ahmet Cagdas-Yumurtaş, Department of Cardiology, Health Sciences University, Dr. Siyami Ersek Training and Research Hospital, Istanbul, Turkey
Veysel Ozan-Tanık, Health Sciences University, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
Gonul Zeren, Department of Cardiology, Health Sciences University, Dr. Siyami Ersek Training and Research Hospital, Istanbul, Turkey
İlhan İlker-Avcı, Department of Cardiology, Health Sciences University, Dr. Siyami Ersek Training and Research Hospital, Istanbul, Turkey
Can Yücel-Karabay, Department of Cardiology, Health Sciences University, Dr. Siyami Ersek Training and Research Hospital, Istanbul, Turkey
Barış Güngör, Department of Cardiology, Health Sciences University, Dr. Siyami Ersek Training and Research Hospital, Istanbul, Turkey
Lale Tokgozoğlu, Hacettepe Medical Faculty, Ankara, Turkey


Background: High-intensity statin (HIS) therapy is widely recommended for secondary prevention after an acute myocardial infarction (AMI). The 2019 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) dyslipidemia guidelines have lowered the target low-density lipoprotein cholesterol (LDL-C) level, which necessitates a more frequent use of nonstatin therapies. Objectives: The objectives of the study were to investigate the rate of LDL-C target attainment for secondary prevention in AMI patients. Methods: This retrospective investigation included 1360 patients diagnosed with AMI in a tertiary heart center. Lipid parameters were collected within 24 h of admission and within 1 year after discharge. The medications used were retrieved from medical records, and the lowest LDL-C levels after statin treatment were used to assess the effectiveness of the therapy. LDL-C target attainment was defined according to the 2016 ESC/EAS dyslipidemia guidelines as an LDL-C level of < 70 mg/dL and a ≥ 50% reduction from baseline. In addition, the rate of LDL-C target attainment according to the 2019 ESC/EAS guidelines was defined as an LDL-C level of < 55 mg/dL and a ≥ 50% reduction from baseline. Results: In total, 502 (36.9%) and 247 (18.2%) patients reached the LDL-C targets according to the 2016 and 2019 ESC/EAS guidelines, respectively. The admission LDL-C levels were significantly lower and HIS treatment was used more frequently in patients who subsequently attained the LDL-C goal. Remarkably, 461 (34%) patients failed to reach the LDL-C goals despite HIS treatment. Only 27 (1.9%) patients were prescribed ezetimibe. Conclusion: The rate of LDL-C goal attainment in AMI patients was low, which indicates the need for combination statin and non-statin lipid-lowering therapies.



Keywords: Statin. Low-density lipoprotein. European Society of Cardiology. Acute myocardial infarction.