Turning the Tide: Early PCSK9 Intervention Post-ACS - Episode 5
Panelists discuss how achieving the low-density lipoprotein cholesterol (LDL-C) target level within 4 to 6 weeks after an acute coronary syndrome (ACS) event remains challenging for many patients due to factors such as suboptimal statin adherence, inadequate treatment intensity, patient concerns, and limited access to additional therapies.
The conversation centers around the question of how many patients achieve the recommended low-density lipoprotein (LDL) targets after a cardiovascular event, the number of which is concerning. A study from Intermountain Health shows that half of patients do not start taking a statin after an acute cardiovascular event. Even more alarming is that many patients never have their LDL levels checked. Given this, the percentage of patients reaching the target of LDL less than 70 is much lower—likely around a quarter at best.
Several factors contribute to this issue, starting with the prescription and follow-through. While most patients are prescribed statins upon discharge, many do not fill the prescription or continue their medication. This could be due to a variety of reasons, including cultural attitudes toward medication, as patients often want to manage their health naturally and may resist lifelong medication regimens. Educating patients about the importance of consistent therapy for reducing long-term cardiovascular risks is crucial.
In addition to patient behavior, there are external barriers, such as misinformation from social media, which may advise patients against statins in favor of unregulated supplements. This, compounded with fears about adverse effects, makes it challenging for clinicians to ensure patients stay on track with therapy. Acknowledging and addressing adverse effects, providing alternatives when necessary, and guiding patients toward reliable health information are essential steps. Ultimately, with the expanding array of treatment options beyond statins, there is greater opportunity to achieve LDL reduction, but it requires consistent engagement and education to overcome these barriers.