232 Analysis of the baseline LDL-Cholesterol level as a predictor in achieving target level of less than 1.8 mmol/l at 90 days after initiation of inclisiran

Background and Aim High levels of Low Density Lipoprotein-C (LDL-C) have been associated with increased cardiovascular mortality. The introduction of Inclisiran in recent years have provided an alternative for patients on maximal dose of statins or intolerant to statins and not achieving their target LDL-C level. This study aims to determine the baseline LDL-C level as a predictor in determining the percentage of patients achieving LDL-C level less than 1.8 mmol/l at day 90 after the first dose of Inclisiran with or without statins. Method This is a retrospective observational study using real world data which we collected the data electronically by looking at patients who received Inclisiran as an addon to their usual lipid lowering therapy with an initial level of below 2.6 mmol/l. Their baseline LDL-C levels were then grouped into different categories and their percentage of achieving target below 1.8 mmol/l were determined and analysed. This target is the cutoff point for high cardiovascular risk as per ESC guidance. Results A total of 69 patients were included in the study. The greatest percentage achieving the target were those with a baseline between 2–3 mmol/l, which was 74%. Of those between 3–4 mmol/l, the percentage reduction was 44%, with 4–5 mmol/l 23% and with 1–2 mmol/l 71%. The analysis showed that none of those with a level above 5 mmol had achieved a target below 1.8 mmol/l. In addition, the percentage reduction in LDL-C in these subgroups were also determined. Those with a baseline between 2–3 mmol/l have the highest percentage reduction of 53% ±11 (95% CI), followed by those between 4–5 mmol/l with 50% ±10 (95% CI), between 3–4 mmol/l 44% ±8 (95% CI). In those with level above 5 mmol/l, they had a reduction of 32% ±11 (95% CI). Surprisingly in those with levels between 1–2 mmol/l, 3 patients had an increase in LDL-C level of 7%, 117% and 197%. Conclusion Baseline LDL-C level can potentially be used as a predictor to determine if patients may achieve the target of below 1.8 mmol/l following the first dose of Inclisiran at day 90, with the best baseline level being 2–3 mmol/l. Our study showed that adding Inclisiran in patients with baseline levels of more than 5 mmol/l did not reach target and the effect can be mitigated in those with low level of 1–2 mmol/l, both of which will need further exploration. Conflict of Interest None