235 Monitoring lipid levels as part of secondary prevention in patients with acute coronary syndrome in an effort to meet the targets set by the national institute for health and care excellence

Introduction Lipid lowering as part of secondary prevention of risk factors in Acute Coronary Syndrome (ACS) is of utmost importance to reduce risk of future cardiac events.1 The need for monitoring of the lipid levels following the cardiac event is important and needs to be carried out in an organised manner. Objectives We aimed to determine if lipid levels were being monitored in patients following ACS and if targets were being achieved according to National institute for Health and care Excellence (NICE) guidelines.2 Methodology We conducted a single centre retrospective observational study of patients presenting with ACS, who underwent either interventional or medical management. Data for 62 patients were investigated out of which 6 did not fulfil our criteria. Fifty-six patients were examined. We looked if cholesterol levels were checked on presentation, monitored routinely after and if targets were not achieved, adding alternative agents were considered. Results Among the 56 patients with ACS, 43 and 13 were male and female respectively with age ranging from 32 to 83 years. 43 patients (76.7%) were treated with Percutaneous Intervention (PCI), 7 (12.5%) had medical management while 6 (10.7%) were treated with Coronary Artery Bypass Graft (CABG). All of the patients had their lipid profile checked at index event, which revealed 6 patients had total cholesterol above 7.5 mmol/l while 1 had more than 9.0 mmol/l. 52 patients (92%) had been started on lipid lowering agents, (statin and others), while 4 were discharged without any agents. We observed that after 3 months, only 22 patients (40%) had their lipid profile checked while 34 patients (60%) were not. Of these 34 patients, 31 patients had their lipid profile checked within the 12 months, however 3 of them did not have them checked at all. We found that among the 56 patients, only 28 patients (50%) had attained low density cholesterol (LDL-C) to the target levels of 2.6 mmol/l. 8 patients had LDL-C levels more than 3.5 mmol/l, at least half of whom were eligible for pro protein convertase subtilsin kexin type 9(PCSK9) inhibitor. Conclusion Our study showed there is a lack of monitoring of lipid levels in patients following their index ACS event. We also found that significant number of patients did not meet the target set by NICE and should be started on secondary agents in addition to statin. References 1. Silverman MG, Ference BA, Im K, et al. Association between lowering LDL-C and cardiovascular risk reduction among different therapeutic interventions: a systematic review and meta-analysis. JAMA 2016;316(12):1289–1297. doi:10.1001/jama.2016.13985 ---- 2. https://cks.nice.org.uk/topics/lipid-modification-cvd-prevention/ Conflict of Interest None