Background
Methods
Study design and setting
ACS and study population
Data sources
Lipid measurements
Lipid-lowering therapy
Demographic and clinical characteristics
Variable definitions
Low-density lipoprotein cholesterol
Lipid-lowering therapy
Statistical analyses
Results
Variable | ACS population, N = 4377 | |||
---|---|---|---|---|
N (%) | LDL-C (mmol/L) during index hospitalizationa | |||
Total | < 1.8 | ≥ 1.8 | No | |
Overall | 4377 | 322 (7.4) | 2718 (62.1) | 1337 (30.5) |
ACS at index date | ||||
AMI | 3891 (88.9) | 275 (85.4) | 2530 (93.1) | 1086 (81.2) |
UA + CAG | 486 (11.1) | 47 (14.6) | 188 (6.9) | 251 (18.8 |
Age, mean ± SD | 67.8 ± 13.6 | 70.4 ± 11.9 | 65.5 ± 13.4 | 71.8 ± 13.3 |
Age groups | ||||
< 40 | 73 (1.7) | 5 (1.6) | 58 (2.1) | 10 (0.7) |
40–49 | 366 (8.4) | 8 (2.5) | 295 (10.9) | 63 (4.7) |
50–59 | 775 (17.7) | 42 (13.0) | 558 (20.5) | 175 (13.1) |
60–69 | 1126 (25.7) | 88 (27.3) | 718 (26.4) | 320 (23.9) |
70–79 | 1067 (24.4) | 103 (32.0) | 622 (22.9) | 342 (25.6) |
≥ 80 | 970 (22.2) | 76 (23.6) | 467 (17.2) | 427 (31.9) |
Gender | ||||
Male | 2787 (63.7) | 219 (68.0) | 1816 (66.8) | 752 (56.2) |
Female | 1590 (36.3) | 103 (32.0) | 902 (33.2) | 585 (43.8) |
Cohabitation | ||||
Yes | 2490 (56.9) | 191 (59.3) | 1611 (59.3) | 688 (51.5) |
No | 1887 (43.1) | 131 (40.7) | 1107 (40.7) | 649 (48.5) |
Ethnicity | ||||
Denmark | 4101 (93.7) | 305 (94.7) | 2533 (93.2) | 1263 (94.5) |
Western | 106 (2.4) | < 5 | 70 (2.6) | < 35 |
Non-western | 170 (3.9) | < 15 | 115 (4.2) | < 45 |
Comorbidity | ||||
Diabetes mellitus | 735 (16.8) | 128 (39.8) | 324 (11.9) | 283 (21.2) |
Chronic Kidney disease | 183 (4.2) | 22 (6.8) | 82 (3.0) | 79 (5.9) |
Socioeconomic position | ||||
< 100,000 DKK | 432 (9.9) | 37 (11.5) | 257 (9.5) | 138 (10.3) |
100,000 – 299,999 | 3497 (79.9) | 261 (81.1) | 2134 (78.5) | 1102 (82.4) |
≥ 300,000 | 448 (10.2) | 24 (7.5) | 327 (12.0) | 97 (7.3) |
LLTb before or during index hospitalization | ||||
Statins | 1338 (30.6) | 233 (72.4) | 608 (22.4) | 497 (37.2) |
Ezetimibe | 21 (0.5) | < 5 | 16 (0.6) | < 5 |
Other non-statins | 13 (0.3) | < 5 | 6 (1.9) | < 10 |
Combinational treatment | 15 (0.3) | < 10 | 6 (1.9) | < 5 |
No treatment | 2990 (68.3) | 79 (24.5) | 2082 (76.6) | 829 (62.0) |
LLT intensityb before or during index hospitalization | ||||
No LLT | 2990 (68.3) | 79 (24.5) | 2082 (76.6) | 829 (62.0) |
Moderate LLTc | 1262 (28.8) | 220 (68.3) | 579 (21.3) | 463 (34.6) |
Intensive LLTd | 125 (2.9) | 23 (7.1) | 57 (2.1) | 45 (3.4) |
Lipid measurements before index hospitalizatione, N (%), mean ± SD | ||||
LDL-C | 2967 (67.8) 2.96 ± 1.12 | 272 (84.5) 1.86 ± 0.68 | 1733 (63.8) 3.22 ± 1.04 | 962 (72.0) 2.80 ± 1.14 |
HDL-C | 2968 (67.8) 1.33 ± 0.43 | 272 (84.5) 1.32 ± 0.48 | 1734 (63.8) 1.31 ± 0.39 | 962 (72.0) 1.37 ± 0.47 |
Total cholesterol | 2995 (68.4) 5.07 ± 1.28 | 272 (84.5) 3.97 ± 0.91 | 1750 (64.4) 5.33 ± 1.20 | 973 (72.8) 4.92 ± 1.31 |
Triglycerides | 2968 (67.8) 1.80 ± 1.23 | 272 (84.5) 1.84 ± 1.43 | 1734 (63.8) 1.86 ± 1.28 | 962 (72.0) 1.69 ± 1.07 |
Baseline demographic and clinical characteristics
LLT utilization and LDL-C levels prior to index hospitalization
LLT utilization and LDL-C goal attainment at follow-up
6-month follow-up
LDL-C (mmol/L) | |||||||
---|---|---|---|---|---|---|---|
6-month follow-upd (N = 2242) | 12-month follow-upe (N = 1547) | ||||||
LLT | Total | < 1.8 | ≥1.8 | Total | < 1.8 | ≥1.8 | |
Before or during index hospitalizationa | 2242 | 912 (40.7) | 1330 (59.3) | 1547 | 604 (39.0) | 943 (61.0) | |
None | 173 (7.7) | 34 (19.7) | 139 (80.3) | 122 (7.9) | 25 (20.5) | 97 (79.5) | |
Moderateb | 1888 (84.2) | 801 (42.4) | 1087 (57.6) | 1282 (82.9) | 519 (40.5) | 763 (59.5) | |
Intensivec | 181 (8.1) | 77 (42.5) | 104 (57.5) | 143 (9.2) | 60 (42.0) | 83 (58.0) | |
LLT | |||||||
Before or during index hospitalizationa | 6-month follow-up | ||||||
None | None | 120/173 (69.4) | 17/120 (14.2) | 103/120 (85.8) | 89/122 (73.0) | 11/89 12.4) | 78/89 (87.6) |
Moderateb | 46/173 (26.6) | < 15 | < 35 | 28/122 (23.0) | < 15 | < 20 | |
Intensivec | 7/173 (4.0) | < 7 | < 7 | 5/122 (4.1) | < 5 | < 5 | |
Yes | None | 123/2069 (5.9) | 41/123 (33.3) | 82/123 (66.7) | 72/1425 (5.1) | 19/72 (26.4) | 53/72 (73.6) |
Moderateb | 1501/2069 (72.5) | 644/1501 (42.9) | 857/1501 (57.1) | 1041/1425 (73.1) | 425/1041 (40.8) | 616/1041 (59.2) | |
Intensivec | 445/2069 (21.5) | 193/445 (43.4) | 252/445 (56.6) | 312/1425 (21.9) | 135/312 (43.3) | 177/312 (56.7) | |
LLT | |||||||
6-month follow-up | 12-month follow-up | ||||||
None | None | – | – | – | 113/161 (70.2) | 15/113 (13.3) | 98/113 (86.7) |
Moderateb | – | – | – | 38/161 (23.6) | < 15 | < 30 | |
Intensivec | – | – | – | 10/161 (6.2) | < 5 | < 10 | |
Yes | None | – | – | – | 66/1386 (4.8) | 13/66 (19.7) | 53/66 (80.3) |
Moderateb | – | – | – | 871/1386 (62.8) | 347/871 (39.8) | 524/871 (60.2) | |
Intensivec | – | – | – | 449/1386 (32.4) | 214/449 (47.7) | 235/449 (52.3) |
12-month follow-up
Stratified by comorbidity (diabetes mellitus and/or chronic kidney disease)
Comorbidity | Total | ACS population, N = 2887 | ||
---|---|---|---|---|
LDL-C (mmol/L) | ||||
< 1.8 | ≥ 1.8 | No | ||
Comorbidity at inclusion (diabetes mellitus and/or chronic kidney disease) | ||||
LDL-C measurement at | ||||
Index hospitalization | 477 | 104 (24.2) | 325 (75.8) | 48 |
6-month follow-up | 417 | 168 (49.7) | 170 (50.3) | 79 |
12-month follow-up | 381 | 128 (51.8) | 119 (48.2) | 134 |
No comorbidity at inclusion | ||||
LDL-C measurement at | ||||
Index hospitalization | 2410 | 115 (7.8) | 1350 (92.2) | 945 |
6-month follow-up | 2239 | 684 (38.7) | 1085 (61.3) | 470 |
12-month follow-up | 2164 | 455 (36.5) | 793 (63.5) | 916 |