Lipid-Lowering Prescription Patterns After a Nonfatal Acute Coronary Syndrome: The Impact of Real-World Evidence on Clinical Practice With LATINO-ACS 2.0
Author(s)
Cristina Gavina, PhD1, Marta Afonso-Silva, MSc2, Catarina Vieira, MSc3, Rita Lopes, PhD4, Cristina Jácome, PhD4, Francisco Araújo, MD5.
1Pedro Hispano Hospital, Matosinhos, Portugal, 2RWE Lead, Novartis Farma - Produtos Farmacêuticos S.A., Porto Salvo, Portugal, 3Medical advisor, Novartis Farma - Produtos Farmacêuticos S.A., Porto Salvo, Portugal, 4MTG Research and Development Lab, Porto, Portugal, 5Hospital dos Lusíadas Lisboa, Lisbon, Portugal.
1Pedro Hispano Hospital, Matosinhos, Portugal, 2RWE Lead, Novartis Farma - Produtos Farmacêuticos S.A., Porto Salvo, Portugal, 3Medical advisor, Novartis Farma - Produtos Farmacêuticos S.A., Porto Salvo, Portugal, 4MTG Research and Development Lab, Porto, Portugal, 5Hospital dos Lusíadas Lisboa, Lisbon, Portugal.
OBJECTIVES: The LATINO-ACS study revealed that at the end of 2022, 90% of acute coronary syndrome (ACS) patients at the local health unit of Matosinhos (ULSM), Portugal, did not meet 2019 ESC/EAS guidelines LDL-C targets, highlighting a significant gap in guideline implementation and the need for rapid lipid-lowering therapy (LLT) optimization post-ACS. ULSM showed high commitment to changing this status quo and launched several initiatives to improve ACS follow-up. The present study (LATINO-ACS 2.0) aimed to evaluate LLT prescription patterns and LDL-C control after an ACS in the two years following the original study and assess progress between both periods.
METHODS: Retrospective cohort study using electronic health records from ULSM between 2022-2024. Eligibility criteria mirrored LATINO-ACS: patients aged 40-80years hospitalized for non-fatal ACS (index date); ≥1 general practice visit in the 3years prior to index date; ≥105 days of follow-up post-index; no hospitalization for stroke or peripheral artery disease. LLT intensity and LDL-C control were analyzed across three stages: S1 (pre-ACS: -365 to -30 days from index date); S2 (near-ACS: -365 to -7 days); S3 (post-ACS: 105 to 395 days). LDL-C targets were based on 2019 ESC/EAS guidelines: S1, <100 mg/dL; S2, <70 mg/dL; S3 <55 mg/dL.
RESULTS: Among 278 patients (median age: 68years; 28.4% women), LLT intensity and LDL-C controls increased notably in 2022-2024 versus 2016-2022. At S1, moderate- and high-intensity LLT use rose to 42.8% and 24.1% (vs. 26.7% and 2.4%). At S2 and S3, high-intensity LLT use reached 57.9% and 56.5% (vs. 12.5% and 16.5%). LDL-C control also improved across all stages: S1 (51.1% vs. 35.1%), S2 (30.6% vs. 19.9%), and S3 (26.3% vs. 10.5%).
CONCLUSIONS: Over two years, prescriptions of higher intensity LLT and LDL-C target attainment rose more than threefold and twofold, respectively, underscoring the impact that real-world evidence can have in driving systemic change and enhancing post-ACS care.
METHODS: Retrospective cohort study using electronic health records from ULSM between 2022-2024. Eligibility criteria mirrored LATINO-ACS: patients aged 40-80years hospitalized for non-fatal ACS (index date); ≥1 general practice visit in the 3years prior to index date; ≥105 days of follow-up post-index; no hospitalization for stroke or peripheral artery disease. LLT intensity and LDL-C control were analyzed across three stages: S1 (pre-ACS: -365 to -30 days from index date); S2 (near-ACS: -365 to -7 days); S3 (post-ACS: 105 to 395 days). LDL-C targets were based on 2019 ESC/EAS guidelines: S1, <100 mg/dL; S2, <70 mg/dL; S3 <55 mg/dL.
RESULTS: Among 278 patients (median age: 68years; 28.4% women), LLT intensity and LDL-C controls increased notably in 2022-2024 versus 2016-2022. At S1, moderate- and high-intensity LLT use rose to 42.8% and 24.1% (vs. 26.7% and 2.4%). At S2 and S3, high-intensity LLT use reached 57.9% and 56.5% (vs. 12.5% and 16.5%). LDL-C control also improved across all stages: S1 (51.1% vs. 35.1%), S2 (30.6% vs. 19.9%), and S3 (26.3% vs. 10.5%).
CONCLUSIONS: Over two years, prescriptions of higher intensity LLT and LDL-C target attainment rose more than threefold and twofold, respectively, underscoring the impact that real-world evidence can have in driving systemic change and enhancing post-ACS care.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
CO159
Topic
Clinical Outcomes, Real World Data & Information Systems
Topic Subcategory
Clinical Outcomes Assessment
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory)