Addressing current challenges in optimization of lipid management following an ACS event: Outcomes of the ACS EuroPath III initiative
Por:
Catapano A.L., De Caterina R., Jukema J.W., Klempfner R., Landmesser U., Schiele F., Sionis A.
Publicada:
1 abr 2023
Ahead of Print:
1 ene 2023
Resumen:
Background: Low-density lipoprotein cholesterol (LDL-C) lowering is key to reduce atherosclerotic disease progression and recurrent events for patients after acute coronary syndrome (ACS). However, LDL-C management for post-ACS patients remains challenging in clinical practice. Hypothesis: The ACS EuroPath III project was designed to optimize LDL-C management in post-ACS patients by promoting guideline implementation and translating existing evidence into effective actions. Methods: Three surveys targeting cardiologists (n = 555), general practitioners (GPs; n = 445), and patients (n = 662) were conducted in Europe, with the aim of capturing information on patient characteristics and treatment during acute phase, discharge and follow-up. GPs’ and patients’ opinions on key treatment aspects were also collected. Based on survey results, international experts and clinicians identified areas of improvement and generated prototype solutions. Participants voted to select the most feasible and replicable proposals for co-development and implementation. Results: Five key areas of improvement were identified: (1) inappropriate treatment prescribed at discharge; (2) lack of lipid guidance in the discharge letter; (3) inadequate lipid-lowering therapy (LLT) optimization; (4) gaps in guideline knowledge and lack of referral practices for GPs; (5) patients’ concerns about lipid management. Proposed solutions for these focus areas included development of a treatment algorithm for the acute phase, a standardized GP discharge letter, an assessment tool for LLT efficacy at follow-up, an education plan for GPs/patients and a patient engagement discharge kit. The standardized GP discharge letter and treatment algorithm have been selected as the highest priority solutions for development. Conclusion: These initiatives have the potential to improve adherence to guidelines and patient management after ACS. © 2023 The Authors. Clinical Cardiology published by Wiley Periodicals LLC.
Filiaciones:
Catapano A.L.:
Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
De Caterina R.:
Division of Cardiovascular, Department of Cardiothoracic and Vascular, Pisa University Hospital, University of Pisa, Pisa, Azienda Ospedaliero-Universitaria Pisana, Pisa, and Fondazione Villaserena per la Ricerca, Città Sant'Angelo, Pescara, Italy
Jukema J.W.:
Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
Netherlands Heart Institute, Utrecht, Netherlands
Klempfner R.:
Cardiac Rehabilitation Institute, Sheba Medical Center, Tel-Aviv University, Tel Aviv, Israel
Landmesser U.:
Department of Cardiology, Charité University Medicine Berlin, German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin Institute of Health (BIH), Berlin, Germany
Schiele F.:
Department of Cardiology, University of Burgundy Franche-Comte, University Hospital Jean Minjoz, Besançon, France
Sionis A.:
Department of Cardiology, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
Green Published, gold, All Open Access; Gold
|