Association of lipid management-related knowledge, attitudes, and practices with LDL-C target attainment in patients with coronary heart disease: a multicenter cross-sectional study

Background Low-density lipoprotein cholesterol (LDL-C) target attainment remains suboptimal in patients with coronary heart disease (CHD). Patients’ knowledge, attitudes, and practices (KAP) regarding lipid management may be associated with LDL-C control; however, evidence from Chinese populations remains limited. Methods This multicenter cross-sectional study included 520 patients with CHD from two hospitals in China. Lipid management-related KAP were assessed using a questionnaire developed specifically for this study. LDL-C target attainment was the outcome. Multivariable logistic regression and receiver operating characteristic analysis were performed. Results Overall, 22.5% of participants (117/520) achieved the LDL-C target. After adjustment for clinical covariates, attitude (OR = 1.136, 95% CI 1.076–1.203; P < 0.001) and practice (OR = 1.213, 95% CI 1.095–1.352; P < 0.001) remained significantly associated with LDL-C target attainment, whereas knowledge did not (OR = 1.013, 95% CI 0.878–1.172; P = 0.855). Adding KAP variables to the clinical model showed incremental within-sample discriminatory value for LDL-C target attainment, with the area under the curve increasing from 0.772 to 0.817 ( P = 0.005). Conclusions Among Chinese patients with CHD, higher lipid management-related attitude and practice scores were significantly associated with LDL-C target attainment, whereas knowledge scores were not. KAP information showed incremental within-sample discriminatory value beyond the available clinical factors. Given the cross-sectional design, self-developed questionnaire, and lack of detailed lipid-lowering treatment information, these findings should be interpreted as exploratory associations rather than evidence of causal or clinically actionable determinants.