Frontiers in Cardiovascular Medicine (Jul 2022)

An intensive, structured, mobile devices-based healthcare intervention to optimize the lipid-lowering therapy improves lipid control after an acute coronary syndrome

  • Sonia Ruiz-Bustillo,
  • Sonia Ruiz-Bustillo,
  • Sonia Ruiz-Bustillo,
  • Sonia Ruiz-Bustillo,
  • Neus Badosa,
  • Neus Badosa,
  • Ignacio Cabrera-Aguilera,
  • Ignacio Cabrera-Aguilera,
  • Ignacio Cabrera-Aguilera,
  • Consol Ivern,
  • Consol Ivern,
  • Marc Llagostera,
  • Diana Mojón,
  • Miren Vicente,
  • Núria Ribas,
  • Núria Ribas,
  • Lluis Recasens,
  • Lluis Recasens,
  • Julio Martí-Almor,
  • Julio Martí-Almor,
  • Julio Martí-Almor,
  • Mercè Cladellas,
  • Mercè Cladellas,
  • Mercè Cladellas,
  • Núria Farré,
  • Núria Farré,
  • Núria Farré,
  • Núria Farré

DOI
https://doi.org/10.3389/fcvm.2022.916031
Journal volume & issue
Vol. 9

Abstract

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AimsDespite the evidence, lipid-lowering treatment (LLT) in secondary prevention remains insufficient, and a low percentage of patients achieve the recommended LDL cholesterol (LDLc) levels by the guidelines. We aimed to evaluate the efficacy of an intensive, mobile devices-based healthcare lipid-lowering intervention after hospital discharge in patients hospitalized for acute coronary syndrome (ACS).Methods and resultsAmbiespective register in which a mobile devices-based healthcare intervention including periodic follow-up, serial lipid level controls, and optimization of lipid-lowering therapy, if appropriate, was assessed in terms of serum lipid-level control at 12 weeks after discharge. A total of 497 patients, of which 462 (93%) correctly adhered to the optimization protocol, were included in the analysis. At the end of the optimization period, 327 (70.7%) patients had LDLc levels ≤ 70 mg/dL. 40% of patients in the LDLc ≤ 70 mg/dL group were upgraded to very-high intensity lipid-lowering ability therapy vs. 60.7% in the LDLc > 70 mg/dL group, p < 0.001. Overall, 38.5% of patients had at least a change in their LLT. Side effects were relatively infrequent (10.7%). At 1-year follow-up, LDLc levels were measured by the primary care physician in 342 (68.8%) of the whole cohort of 497 patients. In this group, 71.1% of patients had LDLc levels ≤ 70 mg/dL.ConclusionAn intensive, structured, mobile devices-based healthcare intervention after an ACS is associated with more than 70% of patients reaching the LDLc levels recommended by the clinical guidelines. In patients with LDLc measured at 1-year follow-up, 71.1% had LDLc levels ≤ 70 mg/dL.

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