Clinical Outcomes Based on the Attainment of Low-Density Lipoprotein Cholesterol Targets in Patients with Acute Coronary Syndrome in Real-World Practice

Objective. A target of low-density lipoprotein cholesterol (LDL-C) <70 mg/dL or ≥50% reduction should be set. This study aimed to explore the information required to attain the optimal goal of lipid control for patients with ACS in real-world practice using big database analysis. Methods. Patient...

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Main Authors: Wei-Chieh Lee, Yi-Hsuan Tsai, Yun-Yu Hsieh, Yen-Nan Fang, Chih-Yuan Fang, Po-Jui Wu, Huang-Chung Chen, Ping-Yen Liu, Hsiu-Yu Fang
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:International Journal of Clinical Practice
Online Access:http://dx.doi.org/10.1155/2022/2292379
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author Wei-Chieh Lee
Yi-Hsuan Tsai
Yun-Yu Hsieh
Yen-Nan Fang
Chih-Yuan Fang
Po-Jui Wu
Huang-Chung Chen
Ping-Yen Liu
Hsiu-Yu Fang
author_facet Wei-Chieh Lee
Yi-Hsuan Tsai
Yun-Yu Hsieh
Yen-Nan Fang
Chih-Yuan Fang
Po-Jui Wu
Huang-Chung Chen
Ping-Yen Liu
Hsiu-Yu Fang
author_sort Wei-Chieh Lee
collection DOAJ
description Objective. A target of low-density lipoprotein cholesterol (LDL-C) <70 mg/dL or ≥50% reduction should be set. This study aimed to explore the information required to attain the optimal goal of lipid control for patients with ACS in real-world practice using big database analysis. Methods. Patients with ACS were enrolled between January 2005 and December 2019, and their medical history was obtained from the Chang Gung Research database. According to the attainment of LDL-C levels, the study population was divided into groups with and without ≥50% reduced LDL-C levels. In the group that achieved ≥50% reduced LDL-C levels, the study population was subdivided into groups with and without achievement of LDL-C level < 70 mg/dL. Results. This study enrolled 14,520 participants, out of whom only 3,367 patients (23.2%) achieved ≥50% reduced LDL-C levels. At the 3-year follow-up periods, higher incidences of cardiovascular (CV) mortality and all-cause mortality were absorbed in patients without ≥50% reduced LDL-C levels, especially in subgroups of hypertension and diabetes mellitus (DM). When comparing different percentages of reduced LDL-C levels, the significantly lowest hazard ratio (HR) of CV and all-cause mortality was noted at ≥50% reduced LDL-C levels (CV mortality; HR: 0.64; all-cause mortality; HR: 0.57). Conclusion. In the ACS population, better clinical outcomes were yielded in patients with ≥50% reduced LDL-C levels, especially in the hypertension and DM populations. However, strict lipid control did not show better clinical outcomes in patients with ≥50% reduction and <70 mg/dL in LDL-C levels.
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spelling doaj-art-f56a70a9e3b0468896af907f4eb0f95a2024-12-02T07:41:35ZengWileyInternational Journal of Clinical Practice1742-12412022-01-01202210.1155/2022/2292379Clinical Outcomes Based on the Attainment of Low-Density Lipoprotein Cholesterol Targets in Patients with Acute Coronary Syndrome in Real-World PracticeWei-Chieh Lee0Yi-Hsuan Tsai1Yun-Yu Hsieh2Yen-Nan Fang3Chih-Yuan Fang4Po-Jui Wu5Huang-Chung Chen6Ping-Yen Liu7Hsiu-Yu Fang8Institute of Clinical MedicineBiostatistics CenterBiostatistics CenterDivision of CardiologyDivision of CardiologyDivision of CardiologyDivision of CardiologyInstitute of Clinical MedicineDivision of CardiologyObjective. A target of low-density lipoprotein cholesterol (LDL-C) <70 mg/dL or ≥50% reduction should be set. This study aimed to explore the information required to attain the optimal goal of lipid control for patients with ACS in real-world practice using big database analysis. Methods. Patients with ACS were enrolled between January 2005 and December 2019, and their medical history was obtained from the Chang Gung Research database. According to the attainment of LDL-C levels, the study population was divided into groups with and without ≥50% reduced LDL-C levels. In the group that achieved ≥50% reduced LDL-C levels, the study population was subdivided into groups with and without achievement of LDL-C level < 70 mg/dL. Results. This study enrolled 14,520 participants, out of whom only 3,367 patients (23.2%) achieved ≥50% reduced LDL-C levels. At the 3-year follow-up periods, higher incidences of cardiovascular (CV) mortality and all-cause mortality were absorbed in patients without ≥50% reduced LDL-C levels, especially in subgroups of hypertension and diabetes mellitus (DM). When comparing different percentages of reduced LDL-C levels, the significantly lowest hazard ratio (HR) of CV and all-cause mortality was noted at ≥50% reduced LDL-C levels (CV mortality; HR: 0.64; all-cause mortality; HR: 0.57). Conclusion. In the ACS population, better clinical outcomes were yielded in patients with ≥50% reduced LDL-C levels, especially in the hypertension and DM populations. However, strict lipid control did not show better clinical outcomes in patients with ≥50% reduction and <70 mg/dL in LDL-C levels.http://dx.doi.org/10.1155/2022/2292379
spellingShingle Wei-Chieh Lee
Yi-Hsuan Tsai
Yun-Yu Hsieh
Yen-Nan Fang
Chih-Yuan Fang
Po-Jui Wu
Huang-Chung Chen
Ping-Yen Liu
Hsiu-Yu Fang
Clinical Outcomes Based on the Attainment of Low-Density Lipoprotein Cholesterol Targets in Patients with Acute Coronary Syndrome in Real-World Practice
International Journal of Clinical Practice
title Clinical Outcomes Based on the Attainment of Low-Density Lipoprotein Cholesterol Targets in Patients with Acute Coronary Syndrome in Real-World Practice
title_full Clinical Outcomes Based on the Attainment of Low-Density Lipoprotein Cholesterol Targets in Patients with Acute Coronary Syndrome in Real-World Practice
title_fullStr Clinical Outcomes Based on the Attainment of Low-Density Lipoprotein Cholesterol Targets in Patients with Acute Coronary Syndrome in Real-World Practice
title_full_unstemmed Clinical Outcomes Based on the Attainment of Low-Density Lipoprotein Cholesterol Targets in Patients with Acute Coronary Syndrome in Real-World Practice
title_short Clinical Outcomes Based on the Attainment of Low-Density Lipoprotein Cholesterol Targets in Patients with Acute Coronary Syndrome in Real-World Practice
title_sort clinical outcomes based on the attainment of low density lipoprotein cholesterol targets in patients with acute coronary syndrome in real world practice
url http://dx.doi.org/10.1155/2022/2292379
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