Coronary disease & ACSCohort study
Long-term secondary prevention and outcome following acute coronary syndrome: real-world results from the Swedish Primary Care Cardiovascular Database
- Retrospective cohort study
Authors' conclusion
This observational long-term real-world study demonstrates low drug adherence and potential for improvement of risk factors after ACS. Furthermore, the study confirms that uncontrolled LDL-C is associated with adverse outcome even in this older population.
Study context
- Population
- Patients with incident acute coronary syndrome (ACS) 2006–2010, Swedish Primary Care Cardiovascular Database of Skaraborg (mean age 75 years, 40% women)
- Participants
- 3,765 patients
- Exposure
- Achieved blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) levels and their association with recurrent ACS and death
- Outcome
- Long-term treatment adherence, risk factor control (BP, LDL-C) and association with recurrent ACS and death
- Follow-up
- Median 4.8 years
Main finding
As reported in the abstract
Recurrent ACS and death by achieved LDL-C
LDL-C 3.0 mmol/L vs LDL-C 1.8 mmol/LHazard ratio (95% CI)
recurrent ACS
1.19(1.00–1.40)
death
1.26(1.08–1.47)
Observational data: associations, not effects.
Further findings
BP <140/90 mm Hg reached
- Year 1
- 58%
- Year 8
- 66%
LDL-C <2.5 mmol/L reached
- Year 1
- 65%
- Year 8
- 56%
Statin adherence (proportion of days covered)
- Range
- 43% to 60%
Yearly risk factor measurement
- Yearly measured BP
- 62%
- Yearly measured LDL-C
- 28%
Original publication
Long-term secondary prevention and outcome following acute coronary syndrome: real-world results from the Swedish Primary Care Cardiovascular Database. Eur J Prev Cardiol. Published 22 December 2023. doi:10.1093/eurjpc/zwad389
Summarised from the published abstract; every number is checked against it