LDL cholesterol control in patients with acute myocardial infarction: Clinical characteristics and achievement of therapeutic goals in a referral hospital (January-June 2025)
Keywords:
acute myocardial infarction, LDL-cholesterol, hydroxymethylglutaryl-CoA reductase inhibitors, atherosclerosis, cardiovascular riskAbstract
Introduction: LDL cholesterol is a crucial risk factor in atherosclerotic disease. Its regular monitoring allows treatment adjustment according to current guidelines, reducing morbidity and mortality from acute coronary syndrome.
Objective: To evaluate the degree of LDL control and achievement of therapeutic goals during follow-up in patients with acute myocardial infarction in a referral hospital.
Methodology: An observational, descriptive, longitudinal study was conducted including patients with acute myocardial infarction admitted to the Hospital Central of the Instituto de Previsión Social, Paraguay, between January and June 2025. Electronic medical records and LDL levels at admission, 1, 3, and 6 months were analyzed. Variables were processed using descriptive statistics. Due to the retrospective nature of the study, informed consent was waived, ensuring confidentiality.
Results: A total of 126 patients were included (72.2% male, mean age 67 ± 10 years). Arterial hypertension (88.1%) and diabetes mellitus (49.2%) were the most prevalent comorbidities. Angiographically, three-vessel disease predominated (46%). Mean baseline LDL was 141.2 ± 34.7 mg/dL, decreasing to 59.6 ± 13.8 mg/dL at six months. Maximum compliance was achieved at the third month (25.4%), decreasing to 16.7% at the sixth month of follow-up. High-intensity statins were prescribed to 96% of patients, but only 1.6% received combination therapy at discharge.
Conclusions: Patients showed a high metabolic burden and severe coronary artery disease, with a critical gap in lipid control and low compliance with international goals. The decline in therapeutic success after the third month suggests loss of adherence or clinical inertia. Statin monotherapy is insufficient, evidencing the need to standardize early combination therapy from hospitalization to optimize secondary prevention.
