Target Achievements of Low-Density Lipoprotein Cholesterol, Blood Pressure, and Glucose in Patients with Diabetes after Acute Coronary Syndrome: Findings from the Chinese Cardiovascular Association Database – iHeart Project

Aim: To evaluate the achievement of metabolic risk factor targets and influencing factors in ACS patients with diabetes during the 12 months after discharge. Methods: We retrospectively analyzed data from the Chinese Cardiovascular Association database-iHeart Project. Patients who were hospitalized with a diagnosis of ACS between 2014 and 2021 and who had at least one measurement record of LDL-C, BP, or HbA1c within 12 months after discharge were included. We further stratified patients by diabetes status and analyzed the correlation between clinical characteristics, measurement strategy, and achievement of targets. Results: Diabetes was identified in 1,027 (27.5%) of the eligible patients. The proportions of patients with diabetes achieving targets of LDL-C, BP, and HbA1c levels were 42.4%, 61.5%, and 43.7%, respectively. However, combined achievement rate was significantly lower in patients with diabetes than patients without diabetes (16.6% vs. 26.6%). Patients with diabetes who underwent the first measurement within three months or had ≥3 measurements within 12 months were positively associated with achieving combined targets. Conclusions: The achievement of multifactorial targets among patients with ACS is suboptimal, particularly among patients with concomitant diabetes. The optimal measurement strategy post-discharge is essential for improving the comprehensive management of metabolic risk factors in ACS patients.