{"id":9014,"date":"2025-10-21T08:47:04","date_gmt":"2025-10-21T07:47:04","guid":{"rendered":"https:\/\/www.library.sath.nhs.uk\/research\/?p=9014"},"modified":"2025-10-21T08:47:05","modified_gmt":"2025-10-21T07:47:05","slug":"lipid-management-post-myocardial-infarction-a-call-for-improved-monitoring-and-therapy-intensification-2025","status":"publish","type":"post","link":"https:\/\/www.library.sath.nhs.uk\/research\/2025\/10\/21\/lipid-management-post-myocardial-infarction-a-call-for-improved-monitoring-and-therapy-intensification-2025\/","title":{"rendered":"Lipid Management Post Myocardial Infarction: A Call for Improved Monitoring and Therapy Intensification (2025)"},"content":{"rendered":"\n

Type of publication:<\/strong><\/p>\n\n\n\n

Conference abstract<\/p>\n\n\n\n

Author(s):<\/strong><\/p>\n\n\n\n

*Bhambra G.; Kukoyi B.; Joshi M.; Tran P.; Lo T.; Ajiboye J.; Oyedeji O.<\/p>\n\n\n\n

Citation:<\/strong><\/p>\n\n\n\n

Heart. Conference: British Cardiovascular Society Annual Conference, BCS 2025. Manchester United Kingdom. 111(Supplement 3) (pp A210-A211), 2025. Date of Publication: 01 Sep 2025.<\/p>\n\n\n\n

Abstract:<\/strong><\/p>\n\n\n\n

Background Lipid management is a cornerstone of secondary prevention in acute coronary syndrome (ACS). Despite established national guidelines, real-world practice often reveal gaps in lipid monitoring and intensification of lipid-lowering therapy. This study investigated these challenges in a large tertiary centre, proposing a streamlined pathway to address these gaps. Methods A retrospective analysis was conducted in 225 ACS patients (92 STEMI and 133 NSTEMI) from July-August 2023. We assessed lipid monitoring on admission and 2-3 months post-discharge, prescription rates of high-intensity statins and use of alternative lipid-lowering therapies. Multivariate logistic regression evaluated the relationship between highintensity statin initiation and lipid monitoring rates on admission and follow-up, adjusted for comorbidities. Results Initial guideline adherence was strong, with 83.1% having lipids checked on admission and 83.6% prescribed high-intensity statins (table 1). After adjusting for ACS type and comorbidities, patients started on high-intensity statin were nearly twice as likely to have lipids checked on admission (90.4% vs. 45.9%, p<0.001). Notably, patients not receiving high-intensity statins were more likely to have a prior history of ACS (43.2% vs 26.1%, p=0.035). Despite the perceived higher severity of STEMI, there was no significant difference in post-discharge lipid-checking rates between STEMI and NSTEMI patients (51.1% vs 53.4%, p=0.735). In terms of follow-up, only 52.4% of patients had lipids rechecked post-discharge, leaving almost half without adequate monitoring. Neither high-intensity statins nor ezetimibe initiation increased the likelihood of follow-up lipids. Among 118 patients with follow-up lipid assessment, 69.5% achieved target levels. However, of the 36 patients (30.5%) not meeting targets, only 3 (8.3%) had therapy intensified limited to the use of ezetimibe, highlighting a critical gap in care. Conclusion This study highlights the dichotomy between strong initial guideline adherence and significant lapses in follow-up care and therapy intensification. Whilst this single- centre study limits generalisability, several interesting observations emerged. The association between high-intensity statin prescription and admission lipid check highlights the importance of fostering a culture of guideline adherence, where attention to one aspect of care positively influences others. Patients with prior ACS were less likely to receive high-intensity statins, potentially due to perceived stability on existing regimen, leading to missed opportunities for therapy intensification. More strikingly, nearly half of the cohort lacked adequate lipid monitoring on follow-up with restricted use of lipid-lowering therapies. This highlights the need for a structured approach involving cardiac rehabilitation and primary care team via the proposed pathway (Figure 1) to ensure better lipid management in this high-risk cohort.<\/p>\n\n\n\n

DOI: <\/strong>10.1136\/heartjnl-2025-BCS.206<\/p>\n\n\n\n

Link to full-text<\/a> [no password required]<\/p>\n","protected":false},"excerpt":{"rendered":"

Type of publication: Conference abstract Author(s): *Bhambra G.; Kukoyi B.; Joshi M.; Tran P.; Lo T.; Ajiboye J.; Oyedeji O. Citation: Heart. Conference: British Cardiovascular Society Annual Conference, BCS 2025. Manchester United Kingdom. 111(Supplement 3) (pp A210-A211), 2025. Date of…<\/span><\/p>\n

Read more Lipid Management Post Myocardial Infarction: A Call for Improved Monitoring and Therapy Intensification (2025)<\/span> ›<\/span><\/a><\/div>\n

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