Impact of obesity on low density lipoprotein plasmatic levels 6 weeks after an acute coronary syndrome

Abstract

Introduction Cardiovascular disease is the leading cause of death. One of the main factors is obesity, which is on the rise. LDL levels below 0.55 g/L are recommended after ACS. To date, there are no specific recommendations for obese subjects. Objective The primary objective was to assess the impact of obesity on LDL-c target attainment 6 weeks after initiation of statin therapy in subjects admitted for ACS. The secondary objectives were to assess the evolution of cholesterol levels and to characterize lipid-lowering treatments. Methods The single-center observational study took place at Montpellier University Hospital and included patients admitted to the ICU for ACS not treated with statins (T0). Biological tests were performed at 6 weeks. At 3 months, a telephone call was made by two pharmacists to collect the results of their biological work-up and any therapeutic modifications. Results The results were analyzed on 286 patients. A total of 39.5% were overweight and 22.7% obese. After hospitalization, 95.4% were prescribed statins. At 6 weeks, LDL cholesterol averaged 1.58 mmol/L, lower in subjects with a BMI greater than 30 kg/m2 (1.32 mmol/L). On average, 49.46% of subjects reached the LDL cholesterol target, with obese subjects achieving a higher rate of 64.9%. There was no significant difference in the prescription of lipid-lowering treatments between the two groups. Conclusion Despite high-intensity statin prescription, the target was achieved by 67.6% of obese subjects and 44.8% of subjects with a BMI of less than 30 kg/m2. This shows that post-SCA management needs to be reinforced for the general population.