Background: Current European Guidelines suggest the use of cardiovascular risk categories
and also recommend using high-intensity statins for patients with acute coronary syndromes (ACS).
Objective: We examined the risk of ACS patients prior to the event, as well as the overall use and intensity
Methods: We enrolled 687 ACS patients (mean age 63 years, 78% males). Low-density lipoprotein
cholesterol (LDL-C) levels upon admission were used to assess attainment of LDL-C targets. Patients
were categorized as very high, high, moderate and low risk based on their prior to admission cardiovascular
(CV) risk. We examined statin use and dosage intensity among patients discharged from the hospital.
Patients were followed for a median period of 189 days.
Results: The majority of the patients (n=371, 54%) were at very high CV risk prior to admission, while
101 patients were at high risk (15%), 147 (21%) moderate risk and 68 (10%) low risk. Interestingly,
LDL-C target attainment decreased as the risk increased (p<0.001). The majority (96%) of patients received
statins at discharge; however, most of them (60.4%) received low/moderate intensity statins and
just 35.9% received the suggested by the Guidelines high-intensity dose of statins. At follow-up, the rate
of patients at high-intensity dose of statins remained similar (34.8%); 6% received no statins at all at
Conclusion: According to our study, the majority of ACS patients are already at high risk prior to their
admission. Further, LDL-C targets are underachieved prior to the event and high-intensity statins are
underutilized in ACS patients at, and post-discharge.