Lipid Abnormalities among Myocardial Infarction Patients and Evidence-based Approach to Improve Lipid Parameters

Low-density lipoprotein cholesterol(LDL-C) is a prognostic biomarker for heart attack, whereas lipoprotein (a)[Lp(a)] and PCSK9 are lipid parameters likely to contribute to residual cardiovascular risk. Our study demonstrated that heart attack patients had improvement in their fasting lipid profile with high-intensity statins(atorvastatin 40mg), but only 33.1% achieved target LDL-C<1.8mmol/L at 3-months post-discharge, with no difference in Lp(a) and PCSK9. Total cholesterol, triglyceride and atorvastatin concentration improved significantly in integrated approach group (increasing atorvastatin dose and medication adherence counseling) at 7-months compared to standard of care approach. Self-reported medication adherence with measuring atorvastatin concentration can reflect real life medication adherence.