PENELOPE 1-year follow-up: legacy effect of a short protocol-led LDL-C-lowering strategy in patients after myocardial infarction.

IF 1.7 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Netherlands Heart Journal Pub Date : 2025-04-01 Epub Date: 2025-02-24 DOI:10.1007/s12471-025-01939-2

Sander van der Brug, Tinka van Trier, Aaram Omar Khader, An-Ho Liem, Astrid Schut, Fabrice Martens, Marco Alings

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引用次数: 0

Abstract

Objective: Lowering low-density lipoprotein cholesterol (LDL-C) reduces the risk of developing atherosclerotic cardiovascular disease (ASCVD). In the PENELOPE study, a guideline-based, protocol-led LDL-C-lowering strategy was applied in patients after myocardial infarction and resulted in 87% reaching target LDL‑C levels of ≤ 1.8 mmol/l within a median of 45 days. This study evaluated PENELOPE's legacy effect on LDL‑C levels after 1 year.

Methods: In the PENELOPE study, 999 patients with a myocardial infarction and a history of ASCVD and/or diabetes mellitus were included. If LDL-C > 1.8 mmol/l, lipid-lowering therapy was intensified in three consecutive steps: (1) high-intensity statin (HIST) monotherapy, (2) HIST + ezetimibe, and (3) HIST + ezetimibe + proprotein convertase subtilisin/kexin type 9 inhibitor (PCSK9i). LDL‑C levels were monitored 4-6 weeks after each step. The primary objective of this study was to assess the prevalence of the LDL‑C target level of ≤ 1.8 mmol/l being maintained after 1 year.

Results: Data of 738 patients (74%) were available for 1‑year follow-up. The target LDL‑C level was met in 471 patients (64%). Median LDL‑C levels changed from 1.5 (1.2-1.7) mmol/l immediately after implementation of the protocol-led strategy to 1.6 (1.3-2.0) mmol/l after 1 year. Major treatment regimens were statin (58%), statin + ezetimibe (30%) and PCSK9i + ezetimibe (+ statin) (7%).

Conclusion: After a myocardial infarction, implementation of a protocol-led LDL-C-lowering strategy resulted in 87% of patients attaining the LDL‑C target level of ≤ 1.8 mmol/l within a median of 45 (32-77) days. At 1‑year follow-up, 64% maintained this target level and the median LDL‑C increased by 0.1 mmol/l.

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PENELOPE 1年随访：心肌梗死后以短期方案为主导的ldl - c降低策略的遗留效应

目的：降低低密度脂蛋白胆固醇（LDL-C）可降低发生动脉粥样硬化性心血管疾病（ASCVD）的风险。在PENELOPE研究中，一种基于指南的、以协议为主导的降低LDL-C策略应用于心肌梗死后患者，结果87%的患者在45天内达到≤ 1.8 mmol/l的目标LDL-C水平。本研究评估了1年后PENELOPE对LDL - C水平的影响。方法：在PENELOPE研究中，纳入了999例心肌梗死、ASCVD和/或糖尿病病史的患者。如果LDL-C > 1.8 mmol/l，则连续三个步骤加强降脂治疗：(1)高强度他汀类药物（HIST）单药治疗，(2)HIST + ezetimibe, (3) HIST + ezetimibe +蛋白转化酶枯草素/ keexin 9型抑制剂（PCSK9i）。在每一步后4-6周监测LDL - C水平。本研究的主要目的是评估1年后LDL - C目标水平≤ 1.8 mmol/l的患病率。结果：738例（74%）患者进行了1年随访。471例患者（64%）达到了目标LDL - C水平。中位LDL - C水平在实施以协议为主导的策略后立即从1.5 (1.2-1.7)mmol/l变化到1年后的1.6 (1.3-2.0)mmol/l。主要治疗方案为他汀类药物（58%）、他汀 +依泽替米贝（30%）和PCSK9i +依泽替米贝（+ 他汀）（7%）。结论：心肌梗死后，实施以协议为主导的LDL-C降低策略，87%的患者在中位45（32-77）天内达到LDL-C目标水平≤ 1.8 mmol/l。在1年的随访中，64%的患者维持了这一目标水平，中位LDL - C增加了0.1 mmol/l。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Netherlands Heart Journal CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

4.70

自引率

5.00%

发文量

审稿时长

6-12 weeks

期刊介绍： The scope of the Netherlands Heart Journal is to contribute to the national and international literature by publishing scientific papers in the field of cardiovascular medicine. It also provides a platform for Continuing Medical Education for cardiologists and those in training for the speciality of cardiology in the Netherlands. The Netherlands Heart Journal is made available to cardiologists, cardiologists in training, cardiopulmonary surgeons, cardiopulmonary surgeons in training, internists and paediatric cardiologists. The journal is the official journal of the Netherlands Society of Cardiology.