Telemedicine lipid-lowering strategy reduced LDL-c from 108.4 to 48.7 mg/dL, with 82.6% achieving <55 mg/dL and LDL-c linked to lower cardiovascular mortality (HR 1.04).
Does a telemedicine-based strategy for lipid control improve LDL-c target achievement and clinical outcomes in patients after an acute coronary syndrome?
A telemedicine-based lipid-lowering strategy effectively achieves stringent LDL-c targets and is associated with reduced cardiovascular mortality in patients following an acute coronary syndrome.
Absolute Event Rate: 0% vs 0%
Abstract Lipid control is a pivotal measure for secondary prevention following an acute coronary syndrome (ACS). However, current registries indicate that only a small proportion of patients achieve the target LDL cholesterol levels. In recent years, telemedicine has been increasingly utilized across various medical fields, particularly in the management of patients after ACS. We aimed to assess the long-term impact of a telemedicine-based strategy for lipid control following ACS. Methods: This prospective study consecutively enrolled patients with ACS in our centre. All patients were discharged on high-intensity statins, and their lipid profiles were assessed one month later. At that point, patients were contacted by phone, and treatment was adjusted according to the therapeutic algorithm of the Spanish Society of Cardiology. These telemedicine visits were conducted monthly until LDL-c levels reached 55 mg/dL. Results: A total of 344 patients were included (mean age: 67.3±12.4 years, 32% women). Baseline characteristics are presented in Table1. The mean baseline LDL cholesterol was 108.4±40.7 mg/dL, which decreased to 48.7±14.4 mg/dL after the intervention. Overall, 82.6% of patients achieved the LDL-c target of 55 mg/dL, 12.8% LDL-c target between 55–69 mg/dL, and the remaining 4.7% had levels between 70–100 mg/dL. The mean time to treatment optimization of 3.2±2.1 months. After a median follow-up of 39±10 months, 43 patients (12.5%) had died. A composite endpoint of 4P-MACE (cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, or unplanned revascularization) occurred in 72 patients (20.9%). Survival probability curves stratified by LDL-c levels at the end of follow-up are displayed in the Figure. In multivariate analysis, LDL-c at the end of follow-up was independently associated with higher cardiovascular mortality (HR 1.04, 95% CI 1.01–1.08, p = 0.024), along with age (HR 1.09, 95% CI 1.02–1.16, p = 0.004) and previous coronary artery disease (HR 4,21 95% CI 1.18-14.9, p = 0.02). Conclusion: A telemedicine-based lipid-lowering strategy effectively achieves stringent LDL-c targets and reduces cardiovascular mortality in a secondary prevention cohort. Probability of survival at follow-up acc
Mendez et al. (Sat,) reported a other. Telemedicine lipid-lowering strategy reduced LDL-c from 108.4 to 48.7 mg/dL, with 82.6% achieving <55 mg/dL and LDL-c linked to lower cardiovascular mortality (HR 1.04).