(179) Low-density Lipoprotein Measurement During and After Hospitalization with Myocardial Infarction in Denmark from 2018 to 2021.

Background: Cardiovascular disease is the leading cause of death worldwide. Coronary heart disease is the most common cardiovascular disease and will often manifest in acute ischemia of the heart and consequent myocardial infarction (MI). Lipid-lowering treatment and thereby reduction of low-density lipoprotein (LDL) in the blood preventing and decreasing atherosclerosis has been a cornerstone since the nineties. Both primary and secondary prevention with lipid-lowering treatment relies on screening and monitoring patients’ LDL, to adjust treatment. Current guidelines recommend a target LDL of < 1.4 mmol/L after MI.

Objectives: To examine LDL levels and frequency of measurement during and after hospitalization with incident MI, and similarly to examine the proportions reaching the treatment goal of an LDL < 1.4mmol/L during one year of follow-up.

Methods: Nation-wide observational study based on the Danish National Health registries between 2018 and 2021.
All incident MI-patients in Denmark with MI-diagnosis from 2018 to 2021 in The Danish National Patient Register, were included in the study, and were followed for up to one year after discharge from the initial MI hospitalization. Patients, whose hospital stays totaled less than twelve hours were excluded to avoid misclassification. Measurements of LDL was obtained from the Register of Laboratory Results for Research.

Results: This study included 24,977 (96%) incident MI patients surviving the initial hospital stay, of those 21,636 (87%) were measured at least once during hospitalization with a median LDL of 2.9 mmol/L (IQR 2.1 to 3.7). During the twelve months follow-up 21,557 (86%) were measured at least once, with a median time until first measurement of 85 days (IQR 52 to 135). A median LDL of 1.6 mmol/L (IRQ 1.2 to 2.0) was determined for the last measurement during follow-up. During the follow-up period 10,262 (41%) patients reached an LDL < 1.4 mmol/L at some point, whereas 16,077 (64%) were reduced < 1.8 mmol/L at some point.

Conclusions: This study finds that a substantial number of MI patients in Denmark are not properly screened and monitored regarding LDL values. Likewise, many patients are not reduced in LDL as recommended by guidelines. This study is a part of a continuing study, examining health utilization after MI (lipid-lowering treatment and healthcare visits).