Determinants of postdischarge low-density lipoprotein cholesterol (LDL-C) testing and target attainment after acute coronary syndrome: A 10-year population-based study
Authors' conclusion
LDL-C follow-up and attainment after ACS remain suboptimal. Patients at risk for absent testing may be recognized before discharge, creating opportunities for proactive intervention. Intensive LLT was associated with better LDL-C control, emphasizing the value of coordinated follow-up strategies.
Study context
- Population
- Patients hospitalized with acute coronary syndrome (ACS) between 2013 and 2023 who survived ≥6 months post-ACSunderwent LDL-C testing 22,722 · did not undergo LDL-C testing 19,334
- Participants
- 42,056 eligible patients
- Exposure
- Factors associated with absence of LDL-C testing and failure to achieve LDL-C < 70 mg/dL
- Testedn = 22,722
- Not testedn = 19,334
- Outcome
- LDL-C testing
- Follow-up
- Within 6 months postdischarge
Methodological detailsconsecutive ACS hospitalizations, large healthcare system, multivariable logistic regression
- Consecutive ACS hospitalizations
- Large healthcare system
- Multivariable logistic regression
Main finding
As reported in the abstract
Observational data: associations, not effects.
Further findings
Factors associated with nontesting
| Comparison | OR (95% CI) | |
|---|---|---|
| Absence of early postdischarge LLT dispensingStrongest predictor of nontesting | 7.90 (7.10–8.81) | |
| Combination therapyLower odds of nontesting | 0.79 (0.69–0.90) | |
| 0.10.31310Odds ratio (log scale) |
LDL-C < 70 mg/dL attainment among tested patients
| Comparison | Tested | Not tested | OR (95% CI) | |
|---|---|---|---|---|
| Combination therapyHigher target attainment | 59.7% | Not reported in the abstract | 1.52 (1.26–1.83) | Not tested: not reported in the abstract |
| No LLTLower attainment | 0.49 (0.42–0.58) | |||
| 0.512Odds ratio (log scale) |
- Factors associated with nontesting — Nontesting associated with younger age, male sex, lower socioeconomic status, and reduced use of lipid-lowering therapy (LLT) at discharge
- all P < .001
LDL-C < 70 mg/dL attainment among tested patients
- LDL-C control improved over time, paralleling evolving guidelines
Original publication
Determinants of postdischarge LDL-C testing and target attainment after acute coronary syndrome: A 10-year population-based study. Am Heart J. Published 11 September 2026. doi:10.
Summarised from the published abstract; every number is checked against it