SRS278 - Analysing the impact of a consultant-led treat-to-target approach to lipid-lowering therapy in abdominal aortic aneurysm (AAA) patients

Abstract Introduction Abdominal aortic aneurysms (AAAs) affect ∼4% of men aged 65–74 and carry substantial cardiovascular risk. Elevated low-density lipoprotein cholesterol (LDL-C) drives atherosclerosis, with each 1 mmol/L reduction lowering major adverse cardiac events (MACE). Despite statins being effective, fewer than 60% of AAA surveillance patients receive therapy. Guidelines recommend intensive lipid-lowering, with targets of <1.8 mmol/L (ESC/ESVS) or ≥40% reduction (NICE). Strategies differ: ‘fire and forget’ (F&F) prescribes statins without monitoring, whereas ‘treat-to-target’ (T2T) adjusts therapy to achieve LDL-C goals. This study compared both approaches. Methods A retrospective audit of 139 AAA surveillance patients (01/2018–12/2022) at Leeds Teaching Hospitals Trust collected demographics, comorbidities, lipid-lowering therapy, LDL-C at 3, 6, and 12 months, and MACE outcomes. Patients were classified as F&F (n = 78) or T2T (n = 61). Data were analysed using SPSS v28; non-parametric LDL-C comparisons used Mann–Whitney U, mean LDL-C reduction used ANOVA, and MACE incidence compared with chi-squared tests. Results T2T patients had lower median LDL-C at 6 (1.8 versus 2.0 mmol/L) and 12 months (1.6 versus 1.8 mmol/L), though differences were not significant. At 3 months, LDL-C was slightly higher in T2T (2.1 versus 2.0 mmol/L). MACE incidence was significantly lower in T2T patients (0.6885 versus 0.9103 per person, P < 0.001). Conclusions T2T was associated with reduced MACE compared with F&F, despite non-significant LDL-C differences. These findings suggest T2T may offer clinical benefit in AAA patients, warranting larger, multi-centre studies to guide wider adoption and improve long-term cardiovascular outcomes.