ArticleCardiovascular drugs and therapy2026
Guideline-directed Low-density Lipoprotein Cholesterol Management After Acute Coronary Syndrome in Patients With Mental Illness: a Population-based Study.
Article in Cardiovascular drugs and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundDespite increased cardiovascular morbidity among patients with mental disorders, real-world data on lipid-lowering therapy (LLT) use and low-density lipoprotein cholesterol (LDL-C) target attainment after acute coronary syndrome (ACS) remain limited. We evaluated disparities in LLT utilization and LDL-C target attainment among patients with and without mental disorders following ACS in a real-world setting.
methodsData of consecutive ACS hospitalizations in a large healthcare system (2013-2023) were analyzed. Patients were stratified by mental illness and compared with controls. LDL-C target attainment and LLT use were assessed at baseline and during early (1-4 months) and late (6-12 months) post-discharge periods. Multivariable logistic regression evaluated independent associations.
resultsAmong 9,192 patients surviving ≥ 1 year after ACS, 32.1% had mental illness. These patients were older, more often female, and had higher atherosclerotic burden (p < 0.001). LDL-C target attainment was lower in patients with mental illness both early (49% vs. 54%) and late (44% vs. 49%) after discharge, with fewer achieving ≥ 50% LDL-C reduction (p < 0.001). High-intensity statin and early ezetimibe use were less frequent (p = 0.005), and non-adherence was higher (9.7% vs. 6.3%, p = 0.001). In adjusted analyses, mental illness was not independently associated with LDL-C target attainment but was linked to lower use of moderate- and high-intensity statins (OR 0.87 and 0.83) and higher likelihood of no LLT use (OR 1.48; p < 0.01).
conclusionsMental disorders were associated with lower LLT intensity and greater treatment gaps after ACS, without independent differences in LDL-C attainment. LDL-C control and combination LLT use remained suboptimal, highlighting persistent gaps in secondary prevention.
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