{
  "abstract": "Introduction The reduction of low-density lipoprotein cholesterol(LDL-C) has been well established as a key strategy in slowing the progression of atherosclerosis and preventing future cardiovascular events in high-risk patients. In individuals diagnosed with acute myocardial infarction(AMI), including ST-elevation myocardial infarction(STEMI) and non-ST-elevation myocardial infarction(NSTEMI), European Society of Cardiology(ESC) guidelines recommend high-intensity statin therapy to achieve a ≥50% reduction in LDL-C or an absolute LDL-C level of <1.4 mmol/L. 1 If targets are not met, the addition of further lipid-lowering therapies should be considered. Although statins are routinely initiated following an AMI, this audit highlights deficiencies in post-event lipid monitoring and suboptimal escalation of therapy in eligible patients who fail to achieve lipid-lowering targets.Objectives This re-audit, conducted in accordance with the 2019 ESC Dyslipidaemia Guidelines and following an initial audit in 2022, 2 aims to assess compliance with four key quality indicators in lipid management for AMI patients:Measurement of a full lipid profile upon hospital admission.Initiation of high-intensity statin therapy (Atorvastatin 80 mg) prior to discharge.Repeat lipid profile and liver function tests at the first outpatient follow-up.Consideration of addition al lipid-lowering agents, such as Ezetimibe, bempedoic acid, or PCSK9 inhibitors, in patients who fail to achieve target LDL-C reduction (>50% reduction from baseline or LDL-C <1.4 mmol/L), or as an alternative therapy in those intolerant to statins.Methods and Results Following exclusion criteria, 200 inpatients diagnosed with AMI between November 1, 2023, and May 31, 2024, at a district general hospital were included in the audit. Data were collected retrospectively from patient case records, clinical notes and a web-based laboratory system to evaluate adherence to the audit criteria.Over the six-month period, none of the four quality indicators met the predefined ≥90% compliance threshold. 78% of thepatients had lipid profile check on admission, an improvement from 47%, and 79% of these had their lipid profile retested on their follow-up appointment, compared to 72% in the prior audit. High-intensity statin therapy was initiated in 63% of patients. 40% of the patients had not had their lipid profile re-tested,hence not known wither optimisation is needed. Among the 70 patients indicated for further lipid-lowering therapy, only 10% received Ezetimibe, 1% received bempedoic acid, and 2% received a combination of Ezetimibe and bempedoic acid. No patients were initiated on PCSK9 inhibitors.Abstract 7-007 Figure 1Abstract 7-007 Figure 2Abstract 7-007 Table 1Conclusion Dyslipidaemia remains a significant modifiable risk factor for cardiovascular morbidity and mortality, yet opportunities for optimal lipid management are frequently missed. Despite strong evidence supporting the efficacy of Ezetimibe, bempedoic acid, and PCSK9 inhibitors in LDL-C reduction, their uptake remains suboptimal. Targeted interventions are required to improve outcomes. Proposed strategies include educational sessions for healthcare professionals, ward-based posters, and real-time monitoring of lipid management metrics. Additionally, a business case has been submitted for the recruitment of an independent prescriber within the cardiac rehabilitation team to optimize lipid-lowering therapy initiation and ensure timely lipid retesting.Conflict of Interest None.References 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J. https://academic.oup.com/eurheartj/article/41/1/111/5556353.Audit on the management of dyslipidaemia in patients presenting with acute myocardial infarction as per ESC guidance in a district general hospital—are we meeting targets? https://heart.bmj.com/content/108/Suppl_1/A133.2.",
  "authors": [
    {
      "affiliations": [
        "Stockport NHS Foundation Trust, UK"
      ],
      "name": "Ala Al-Qudah"
    },
    {
      "affiliations": [
        "Stockport NHS Foundation Trust, UK"
      ],
      "name": "Charmaine Ncube"
    },
    {
      "affiliations": [
        "Stockport NHS Foundation Trust, UK"
      ],
      "name": "David Ajao"
    },
    {
      "affiliations": [
        "Stockport NHS Foundation Trust, UK"
      ],
      "name": "Eve Wilson"
    },
    {
      "affiliations": [
        "Stockport NHS Foundation Trust, UK"
      ],
      "name": "Marwah Almadhi"
    },
    {
      "affiliations": [
        "Stockport NHS Foundation Trust, UK"
      ],
      "name": "Raahim Sarwar"
    },
    {
      "affiliations": [
        "Stockport NHS Foundation Trust, UK"
      ],
      "name": "David Lai"
    }
  ],
  "title": "7-007 Re-audit on the management of dyslipidaemia in patients presenting with acute myocardial infarction and the use of new lipid lowering therapies, are we meeting targets?",
  "uid": "f15af783-c2ae-5eb7-9160-5c15cc4bc745"
}