Guideline LDL-C Threshold Achievement in Acute Myocardial Infarction Patients: A Real-World Evidence Study Demonstrating the Impact of Treatment Intensification with PCSK9i

• DOI: 10.1007/s40119-022-00300-7
• Publication Date: 2023-01-19T08:29:22Z
• Authors: Erin S. Mackinnon; Bryan Har; Salimah Champsi; Rajvi J. Wani; Lee Geyer; Eileen Shaw; Megan S. Farris; Todd J. Anderson
• Keywords: Ezetimibe; Evolocumab; Guideline

A high proportion of Canadian patients with acute myocardial infarction (AMI) do not achieve the threshold low-density lipoprotein cholesterol (LDL-C) levels recommended by Cardiovascular Society in 2021. This increases risk subsequent atherosclerotic cardiovascular disease (ASCVD) events. Here, we assess LDL-C and achievement among lipid-lowering therapies (LLT) received post-AMI. retrospective cohort study identified AMI between 2015 2019 was conducted using administrative health databases Alberta, Canada. Patients were grouped their highest-intensity LLT post-AMI (proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) + another LLT; PCSK9i alone; ezetimibe statin; statins (high, moderate, low intensity); or alone), available examined year before after dispense date. The included 15,283 patients. In on LLT, median [95% confidence interval (CI)] decreased from 2.7 (2.3–3.4) to 0.9 (0.5–1.2) mmol/l treatment, largest decrease treatment groups. statin high-intensity groups, (95% CI) values 1.5 (1.5–1.6) 1.4 (1.4–1.4) mmol/l, respectively. below 1.8 increased 77.7% PSCK9i group compared 45.4 32.4% Intensification results a greater achieving versus alone. Increased focus thresholds additional as required may benefit patient outcomes.