Care pathway in patients after myocardial infarction in Denmark − healthcare and drug utilization

Background

Following myocardial infarction (MI), patients are recommended to lower their low-density lipid cholesterol (LDL-C) levels and undergo cardiac rehabilitation to prevent recurrent events. Although lowering LDL-C is vital post-MI, many patients fail reaching sufficient levels, resulting in recurrent cardiovascular events. The aim of the study was therefore to investigate the follow-up and the utilisation of lipid lowering therapy one year after MI.

Methods

This register-based nationwide Danish observational study included all hospitalized patients with an incident MI from 2018 to 2021, discharged alive. Patients were followed for one year after discharge with respect to LDL-C measurements, contacts with different healthcare actors, and lipid lowering therapy.

Results

A total of 24,977 patients were included. During follow-up, the incidence of having an LDL-C measured once and twice were 87 % and 67 %, respectively. The incidence of patients visiting a cardiology department, general practitioner with an LDL-C measurement, and having an acute hospital contact were 66 %, 70 %, and 48 %. Statin therapy was redeemed by most patients at least once (87 %) or twice (82 %), while ezetimibe (16 %) and other drugs were prescribed less frequently. Younger, higher educated, less comorbid males with LDL-C ≥ 1.4 mmol/L at hospitalization were more likely to be followed-up with LDL-C measurement or visit to a cardiology department post-MI.

Conclusion

These findings show that a large proportion of patients are not receiving lipid lowering therapy or are not monitored according to guidelines one year after an MI. This suggests a further need for monitoring MI patients with LDL-C levels and healthcare visits.