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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). 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. 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. 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. Copyright © 2023 Elsevier B.V. All rights reserved.

Citation

Marco Ferlini, Andrea Munafò, Ferdinando Varbella, Fabrizio Delnevo, Martina Solli, Daniela Trabattoni, Emanuela Piccaluga, Antonino Cardile, Paolo Canova, Roberta Rossini, Dario Celentani, Fabrizio Ugo, Vittorio Taglialatela, Falvio Airoldi, Andrea Rognoni, Fabrizio Oliva, Italo Porto, Stefano Carugo, Battistina Castiglioni, Corrado Lettieri, Alessandra Chinaglia, Alessia Currao, Giuseppe Patti, Luigi Oltrona Visconti, Giuseppe Musumeci. Achievement of target LDL-cholesterol level in patients with acute coronary syndrome undergoing percutaneous coronary intervention: The JET-LDL registry. International journal of cardiology. 2024 Feb 15;397:131659

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PMID: 38101704

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