Prospective evaluation of lipid management following acute coronary syndrome in Saudi Arabia

OBJECTIVES: To evaluate LDL-C control in patients within 6 months after hospitalization for ACS in Saudi Arabia. METHODS: This multicenter, prospective, observational registry evaluates LDL-C control in patients within 6 months after hospitalization for ACS in Saudi Arabia between December 2017 and October 2019. The study aimed at recruiting 170 patients and data were collected retrospectively at baseline and prospectively at 2 subsequent visits. RESULTS: 201 patients were included at baseline, 193 completed the 3-month visit and 186 completed the 6-month visit. Post-ACS, virtually all patients were prescribed high-intensity statins and LDL-C levels decreased consistently. However, at LDL-C target assessment, 57.1% of patients still had LDL-C levels >55 mg/dL, while 62.6% of patients had achieved LDL-C level decrease >50%. The composite milestone of LDL-C decrease >50% and LDL-C levels <55 mg/dL was met by 20.6% of study patients. Importantly, 37% of patients did not have LDL-C reading post-ACS and the primary outcome was only valuable for 126 out of 201 patients (63%). CONCLUSION: Levels and decrease of LDL-C from baseline achieved in this study are suboptimal, according to updated 2019 ESC/EAS guidelines. While statins were prescribed to all patients post-ACS, the recommended add-on treatments were largely overlooked. Gaps in dyslipidemia management linger, despite clear updated guidelines.