Impact of obesity on low density lipoprotein plasmatic levels 6 weeks after an acute coronary syndrome

Introduction: Cardiovascular disease is the leading cause of death. One of the main factors is obesity, which is on the rise. LDL levels below 0.55 g/L are recommended after ACS. To date, there are no specific recommendations for obese subjects.

Objective: The primary objective was to assess the impact of obesity on LDL-c target attainment 6 weeks after initiation of statin therapy in subjects admitted for ACS. The secondary objectives were to assess the evolution of cholesterol levels and to characterize lipid-lowering treatments.

Methods: The single-center observational study took place at Montpellier University Hospital and included patients admitted to the ICU for ACS not treated with statins (T0). Biological tests were performed at 6 weeks. At 3 months, a telephone call was made by two pharmacists to collect the results of their biological work-up and any therapeutic modifications.

Results: The results were analyzed on 286 patients. A total of 39.5% were overweight and 22.7% obese. After hospitalization, 95.4% were prescribed statins. At 6 weeks, LDL cholesterol averaged 1.58 mmol/L, lower in subjects with a BMI greater than 30 kg/m² (1.32 mmol/L). On average, 49.46% of subjects reached the LDL cholesterol target, with obese subjects achieving a higher rate of 64.9%. There was no significant difference in the prescription of lipid-lowering treatments between the two groups.

Conclusion: Despite high-intensity statin prescription, the target was achieved by 67.6% of obese subjects and 44.8% of subjects with a BMI of less than 30 kg/m². This shows that post-SCA management needs to be reinforced for the general population.