{
  "abstract": "Introduction ESC Dyslipidemia guidelines have established therapeutic targets in different risk stratification cohorts for prevention of cardiovascular events. This study aimed to characterise a sample of these patients and the department’s achievement of targets.Methods Very high risk patients, defined by the ESC 2019 guidelines, were identified following a retrospective analysis of all patient letters that attended the Cardiology Outpatient department in July 2024. Patients‘ records were reviewed further for relevant comorbidities, recent lipid levels and lipid lower therapies (LLTs).Results 957 patient charts were reviewed and 33% were identified as very high risk ( table 1). Of these, the average age was 70.67 years old (SD 11.61), with 69% male. 49% had previously documented PCI. 3% of patients had no lipids recorded, these were included in patient characteristics but not further analysis. 35% of patients achieved target LDL< 1.4. 62% of patients were off target LDL, with an average LDL of 2.1mmol/L (SD 0.67). 89% of all patients were on a statin, whilst 28% were on ezetimibe. The most common statin prescribed was Atorvastatin (average dose 58.1mg (SD 24.79)). Significantly only 21% were on maximum LLT, defined as Rosuvastatin 40mg/atorvastatin 80mg and Ezetimibe. Full results are laid on in tables I and II below.Conclusions This Study highlights that many patients are not achieving new ESC guideline targets and the need for improvement in secondary prevention management. There is significant room for uptitration of patient medications to achieve this with higher dose of Stains, increased ezetimibe prescription and the utilisation of newer therapies, such as bempedoic acid and PSK9 inhibitors. A repeat study, following the recent approval of bempedoic acid, to track improvement could be of value. This research highlights the need for specialist clinics to identify very high risk patients, monitor lipid levels regularly and titrate medications to maximum tolerated doses.Abstract 89 Table 1Very high risk patient characteristics On Target Off Target All patients Total Patients 35% (111) 62% (197) 317 (9 w/o lipids) Average Age (yrs) 72.84 (SD 10.36) 69.36 (SD12.21) 70.67 (SD 11.61) Sex M/F% 83 17 63 37 69 31 Hypertension% 70 61 64 Previous PCI% 48 47 49 CABG% 16 16 16 CKD% 20 15 16 DM% 27 21 23 CVA/TIA% 23 27 25 Statin Intolerance% 0.9 5 3.4 LDL mmol/L 1.04 (SD 0.37) 2.1 (SD 0.67) 1.71 (SD 0.77) HDL mmol/L 1.21 (SD 0.45) 1.33 (SD 0.4) 1.29 (SD 0.42) Abstract 89 Table 2Patient medications On target (111) Off target (197) Both groups (308) Statin% 95 85 89 Atorvastatin Total Number% 62 61 62 Mean Dose (mg) 57.71 (SD 25.03) 58.33 (SD 24.74) 58.1 (SD 24.79) Rosuvastatin Total Number% 32 20 24 Mean Dose (mg) 33.14 (SD 11.31) 29.12 (SD 14.71) 31 (SD13.3) Simvastatin Total Number% 0.09 3 2.3 Mean Dose (mg) 80 33.12 (SD 22.82) 38.33 (26.46) Pravastatin Total Number% 0 2 2 Mean Dose (mg) / 30.00 (SD 14.14) 30.00 (SD 14.14) Ezetimibe% 23 30 28 Fibrate% 2.7 0.5 1.3 On Max LLT% 21 21 21 Antiplatelet% 67 73 71 Medication change in clinic% 3 18 12",
  "authors": [
    {
      "affiliations": [
        "Beaumont Hospital, Dublin, Ireland"
      ],
      "name": "J Dover"
    },
    {
      "affiliations": [
        "Beaumont Hospital, Dublin, Ireland"
      ],
      "name": "L Sarpong"
    },
    {
      "affiliations": [
        "Beaumont Hospital, Dublin, Ireland"
      ],
      "name": "J Sokan"
    },
    {
      "affiliations": [
        "Beaumont Hospital, Dublin, Ireland"
      ],
      "name": "C Aiken"
    },
    {
      "affiliations": [
        "Beaumont Hospital, Dublin, Ireland"
      ],
      "name": "K Fitzgerald"
    },
    {
      "affiliations": [
        "Beaumont Hospital, Dublin, Ireland"
      ],
      "name": "N McEvoy"
    },
    {
      "affiliations": [
        "Beaumont Hospital, Dublin, Ireland"
      ],
      "name": "BF McAdam"
    }
  ],
  "title": "89 Analysis of lipid management in a very high risk patient cohort in a tertiary centre cardiology outpatient department",
  "uid": "8166d2e7-d63c-54ea-bff0-2df8b97f897b"
}