Secondary prevention and management of dyslipidaemia in patients with coronary artery disease on statin therapy in a tertiary academic centre in Johannesburg

Optimal low-density lipoprotein cholesterol (LDL-C) control in patients with established atherosclerotic cardiovascular disease (ASCVD) is defined as LDL-C levels less than 1.4 mmol/L and a reduction of ≥ 50% in baseline LDL-C levels. This study aims to assess LDL-C control in patients with ASCVD on statin treatment in a tertiary academic hospital. We conducted a cross-sectional study on patients with ASCVD on statin therapy and compared LDL-C levels at the time of presentation with coronary syndromes with the most recent LDL-C obtained during follow-up visits. There were 458 patients with coronary syndromes. After a median duration of 17 months (interquartile range [IQR]: 7-31), 93 (20.3%) patients had optimal LDL-C control. A history of previous coronary artery disease or stroke (odds ratio [OR]: 1.73; 95% confidence interval [CI]: 1.05-2.85; p = 0.031) increased the risk of poor LDL-C control. Only 20.3% of patients with ASCVD on statins achieved the guideline-recommended LDL-C target.