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The following is a summary of “Inadequate Intensification of LDL-cholesterol lowering therapy after coronary revascularization: Insights from the GOULD registry,” published in the December 2024 issue of Cardiology by Peterson et al.  

Individuals with a history of coronary revascularization are at higher risk for subsequent cardiovascular events and all-cause mortality. Lowering low-density lipoprotein cholesterol (LDL-C) levels after revascularization helps reduce these risks.  

Researchers conducted a prospective study to evaluate LDL-C-lowering therapies among individuals with and without prior coronary revascularization.  

They compared baseline and 24-month follow-up LDL-C levels and lipid-lowering therapy (LLT) strategies in the GOULD registry, analyzing 5,006 individuals, with 2,195 (43.8%) having prior revascularization.  

The results showed that individuals with prior coronary revascularization had lower baseline LDL-C levels (99.2 mg/dL vs. 102.5 mg/dL; P<0.001) and were more likely to be on intensive LLT (52.8% vs. 42.7%; P<0.001). At 24 months, they showed slight reductions in LDL-C (−15.6% vs. −13.7%; P=0.145) and were more likely to be on intensive LLT (61.9% vs. 51.5%; P<0.001). Similar LDL-C reductions were observed in the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor group, regardless of revascularization status.  

They concluded that despite better baseline LDL-C management, few individuals met the <70 mg/dL goal, and LLT was rarely escalated, highlighting the need for improved treatment strategies in this population.  

Source: internationaljournalofcardiology.com/article/S0167-5273(24)01538-9/fulltext