ArticleLipids in health and disease2026
Therapeutic inertia and lipid-lowering treatment modification after acute coronary syndrome: a longitudinal real-world study using a lagged decision-outcome design.
Article in Lipids in health and disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIntensive low-density lipoprotein cholesterol (LDL-C) lowering after acute coronary syndrome (ACS) is recommended to reduce cardiovascular risk, but real-world attainment of LDL-C targets remains suboptimal. Therapeutic inertia and varying lipid-lowering strategies may contribute to this gap, but their longitudinal impact is not well characterized.
methodsIn this retrospective longitudinal study, ACS patients with repeated follow-up visits (6–54 months) were evaluated. Lipid-lowering treatment strategies were categorized as no change/discontinuation, combination therapy, dose up-titration, or switching/intensification. A lagged decision–outcome design linked treatment strategies at Visit Tn to LDL-C target attainment at Tn+1. Generalized estimating equations and mixed-effects logistic regression models were used to assess associations with subsequent LDL-C target attainment using the 2016 guideline (< 1.8 mmol/L). For sensitivity analyses, the 2023 guideline was applied (< 1.4 mmol/L).
resultsA total of 1,731 ACS patients were included, with follow-up visits at 6–54 months. Combination therapy was the most frequently used strategy, followed by dose up-titration and switching/intensification. Notably, 10–15% of visits had no treatment adjustment. Treatment modification was significantly associated with improved LDL-C target attainment. Combination therapy showed the strongest effect (OR 0.25, 95% CI: 0.21–0.30), followed by dose up-titration (OR 0.48, 95% CI: 0.40–0.58) and switching/intensification (OR 0.71, 95% CI: 0.59–0.86). Therapeutic inertia was linked to more than double the risk of persistent LDL-C non-attainment (OR 2.46, 95% CI: 2.09–2.90).
conclusionsIn ACS patients, lipid-lowering treatment modification, particularly combination therapy, was associated with improved LDL-C target attainment, whereas therapeutic inertia was detrimental. Proactive treatment adjustment is crucial for improving secondary prevention in real-world practice.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.