Key result
In patients with acute coronary syndrome, the risk of major adverse cardiovascular events (9.8% overall at 24 months) was independent of statin treatment intensity.
Why the study?
Real-world data on post-ACS lipid management strategies and the association of lipid-lowering therapies with MACE risk were needed.
Does high-intensity statin therapy compared to moderate-intensity statin therapy reduce MACE and improve LDL-C goal achievement in patients with acute coronary syndrome?
Observational (n=1,053)
Yes
Does high-intensity statin therapy compared to moderate-intensity statin therapy reduce MACE and improve LDL-C goal achievement in patients with acute coronary syndrome?
Despite widespread use of high-intensity statins post-ACS, LDL-C goal achievement remains low (29.7%), highlighting a significant gap between clinical practice and guideline recommendations.
Background:The Observation Study of Lipid Management and Risks in Patients with Acute Coronary Syndrome in Korea (OLA-K) and the Acute Coronary Syndrome Korea Path (K-PATH) survey were designed to obtain real-world data on post-acute coronary syndrome (ACS) lipid management strategies and assess the association of lipid-lowering therapies (LLTs) with the risk of major adverse cardiovascular events (MACE).Methods: OLA-K was a 24-month prospective, multicenter, observational study assessing the association between LLTs, MACE incidence rates, and the achievement of low-density lipoprotein cholesterol (LDL-C) goals.A total of 1,053 patients with ACS were enrolled and followed up for 24 months from 2018 to 2022.The K-PATH survey collected information on post-ACS lipid management strategies. Results:The mean baseline LDL-C level was 108.7 ± 45.4 mg/dL.Overall, at 24 months, 103 (9.8%) patients experienced MACE, with a median time to event of 7.6 (6.3-10.8)months.No difference was observed in the MACE incidence rate between patients receiving highintensity and moderate-intensity statins.At 24 months, 29.7% of patients achieved the LDL-C goal as per the 2018 Korean guidelines, which recommended LDL-C levels < 70 mg/ dL for very high-risk patients, including those with ACS.According to the K-PATH survey, investigators expected that 40% and 80% of patients would achieve the LDL-C goal at visit 1 and after 6-12 months, respectively.Conclusions: The findings of this study suggest that the risk of MACE and its individual components were independent of statin treatment intensity at 24 months.Despite widespread use of high-intensity statin therapy, the percentage of ACS patients reaching lipid target goals remains low.Our findings reveal a significant gap between clinical practice and investigators' perceptions regarding LDL-C management and goal achievement.This implementation gap underscores the necessity for more intensive lipid management strategies to optimize therapeutic outcomes in this high-risk cardiovascular population.
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Lee et al. (2025) conducted an observational in Acute Coronary Syndrome (n=1,053). High-intensity statins vs. Moderate-intensity statins was evaluated on Major adverse cardiovascular events (MACE). In patients with acute coronary syndrome, the risk of major adverse cardiovascular events (9.8% overall at 24 months) was independent of statin treatment intensity.
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