LDL-C levels rose from 45 mg/dL at discharge to 52 mg/dL after 1-2 years with LDL-C <55 mg/dL dropping from 78.4% to 53%, showing deteriorated long-term control.
Does primary care follow-up after discharge from cardiac rehabilitation maintain long-term lipid control and treatment adherence in low-risk ischemic heart disease patients?
Long-term lipid control significantly worsens after patients with ischemic heart disease are discharged from cardiac rehabilitation to primary care, highlighting the need for better continuity-of-care pathways.
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Abstract Introduction Secondary prevention in patients with ischemic heart disease is essential to reduce cardiovascular morbidity and mortality. Cardiac rehabilitation programs play a crucial role in managing risk factors; however, concerns remain regarding long-term control once these patients are discharged to primary care. This study presents the results of lipid control and treatment adherence in our cardiac rehabilitation unit. Objectives The aim of this study is to assess lipid control and treatment adherence between one and two years after patients are discharged from the cardiac rehabilitation unit to primary care for follow-up. Methods A retrospective observational study was conducted on 241 low-risk patients with ischemic heart disease and significant angiographic lesions (70%), excluding MINOCA and coronary dissection. These patients were discharged to primary care between January 1, 2022, and December 31, 2023, after completing an in-person cardiovascular prevention and rehabilitation program. Lipid profile results were collected from the latest laboratory tests performed between six months after discharge and February 2025. The use of high-intensity statins was 94%, and combination therapy was 88% prior to program discharge (Table 1). Results A statistically significant difference was found in the median LDL-C levels at program discharge: 45 35-54 mg/dL compared to 52 42-67 mg/dL between one and two years post-discharge (p=0.0001). The percentage of patients with LDL-C 55 mg/dL was 78.4% at program discharge versus 53% one year after discharge. Possible causes of poor long-term control included non-renewal of medication in 5.4% of patients and a reduction in the intensity of lipid-lowering therapy in 14.5% of cases. Independent statistically significant predictors of poor long-term lipid control in multivariate analysis included the absence of an annual lipid panel (18% of patients), higher baseline LDL-C and lipoprotein(a) levels, and female sex (Table 2). Conclusions The implementation of a structured cardiac rehabilitation program in our unit has proven effective in controlling lipid levels in patients with ischemic heart disease, achieving superior results compared to previous European studies such as EUROASPIRE V. However, long-term control remains inadequate, highlighting the need to establish continuity-of-care pathways with primary care to maintain the lipid control targets achieved during cardiac rehabilitation programs.
Arroyo et al. (Sat,) reported a other. LDL-C levels rose from 45 mg/dL at discharge to 52 mg/dL after 1-2 years with LDL-C <55 mg/dL dropping from 78.4% to 53%, showing deteriorated long-term control.