Lipid lowering treatment after percutaneous coronary intervention: data from the large contemporary ZON-HR registry

Abstract

Abstract Background Low density lipoprotein-C (LDL-C) reduction in patients who underwent percutaneous coronary intervention (PCI) is recommended by ESC guidelines to prevent ischemic events. This is mainly achieved by secondary prevention with lipid lowering treatment. The ‘’Zuid-Oost Nederland Heart Registry’’ (ZON-HR) is a multicentre prospective registry designed to improve secondary prevention after PCI by a patient-tailored approach. Purpose To describe the use of lipid lowering treatment in patients who underwent PCI in the ZON-HR. Methods Since November 2020 data from all 4628 patients who underwent PCI were included in four hospitals. Patient characteristics, LDL-C values at baseline and medication at discharge were collected. The association between predefined variables and lipid lowering treatment was assessed with multivariable logistic regression. Results LDL-C at baseline was available in 2325 patients. The mean age was 67.8 year and 73.5% was male (table 1). ACS patients had a significantly higher baseline LDL-C value compared with CCS patients (2.81 mmol/l vs 2.45 mmol/l). However, even in CCS patients LDL-C values were >2 mmol/L. There was a different pattern in lipid lowering treatment at discharge after ACS or CCS. Statins were prescribed significantly more frequent in ACS patients, while ezetimibe was prescribed significantly more frequent in CCS patients compared to ACS patients. Mono and combination therapy was prescribed more often in ACS patients compared to CCS patients. Increasing age and CCS indication for PCI were predictors for not receiving any lipid lowering medication at discharge. Also, patients with a higher LDL-C baseline value had a smaller chance to receive lipid lowering medication at discharge. Conclusion LDL-C reduction is the cornerstone of secondary prevention after PCI for CCS and ACS. 8.9% of ACS and 18.2% of CCS patients receive no lipid lowering treatment. Also, patients with scheduled PCI (CCS) had LDL-C values above target. Age and CCS are independent predictors for not receiving lipid lowering treatment. ZON-HR will develop and integrate initiatives to improve lipid lowering secondary prevention.Baseline characteristicsPredictors lipid lowering medication