Coronary disease & ACSCohort study

Determinants of postdischarge low-density lipoprotein cholesterol (LDL-C) testing and target attainment after acute coronary syndrome: A 10-year population-based study

Am Heart JPublished

  • population-based study
  • consecutive acute coronary syndrome (ACS) hospitalizations
  • large healthcare system
  • multivariable logistic regression

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

Main finding

As reported in the abstract

LDL-C testing · within 6 months postdischarge

Observational data: associations, not effects.

Further findings

Factors associated with nontesting

ComparisonOR (95% CI)
Absence of early postdischarge LLT dispensing · strongest predictor of nontesting7.90 (7.10–8.81)
Combination therapy · lower odds of nontesting0.79 (0.69–0.90)

LDL-C < 70 mg/dL attainment among tested patients

ComparisonTestedNot testedOR (95% CI)
Combination therapy · higher target attainment59.7%Not reported in the abstract1.52 (1.26–1.83)
No LLT · lower attainment0.49 (0.42–0.58)
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:10.1016/j.ahj.2026.107607

Summarised from the published abstract; every number is checked against it