66 Optimising post-MI lipid treatment: experience from a UK district general hospital

Introduction Intensive control of LDL cholesterol (LDL-C) following myocardial infarction (MI) are recommended by European Society of Cardiology (ESC) guidelines, to improve clinical outcomes. In this retrospective analysis, we report experiences and trends of lipid management by clinical cardiologists from a UK District General Hospital. Methods Post-MI patients on high-intensity statin not meeting Low Density Lipoprotein-Cholesterol (LDL-C) targets of <1.4 mmol/L at first post-MI clinic follow-up were included for a second follow-up 3 months later at the lipid clinic. Lipid profiles were done at baseline (MI admission), post-MI clinic follow-up and lipid clinic follow-up. Cardiovascular (CV) risk factors, lipid profiles at post-MI clinic and lipid clinic follow up, changes to lipid treatment and lipid MDT outcomes were recorded on Excel and statistically analysed. Results Fifty six percent of patients in the lipid clinic had ST-elevation MI. Baseline CV risk factors included hypertension (41%), diabetes (18%), family Hx 291(52.8%), smoking (60%), prior CAD/ MI (9%). LDL during index admission (mean+/-standard deviation [SD]) was 3.17 +/-1.28 mmol/l; total cholesterol was 5.05+/-1.41 mmol/l. 62% of patients had LDL> 1.4 mmol/L. At first follow up (i.e. post-MI clinic), mean LDL-C was 2.12+/-0.69 mmol/l and cholesterol was 4.06 +/-0.93 mmol/l. Only 5% had met the ESC LDL target <1.4 mmol/l. At time of referral to the lipid clinic, 32% had achieved LDL targets; 94% of those referred to lipid clinic were established on atorvastatin; 82% were on Ezetimibe. Mean LDL-C was 1.82 +/-0.80 mmol/l and cholesterol was 3.76+/- 0.91 mmol/l. 82% of patients were discharged from the lipid clinic. Ezetimibe was further added in 11% of patients, 7% were started on Inclisaran,10% were started on bempedoic acid and 18% were further referred to lipid MDT at a tertiary centre. Conclusion In this analysis, we demonstrate the feasibility and importance of follow-up clinics for optimising lipid lowering therapy to intensive targets in post-MI patients by clinical cardiologists at DGH level. Conflict of Interest None