IMR Press / RCM / Volume 23 / Issue 10 / DOI: 10.31083/j.rcm2310327
Open Access Original Research
Low-Density Lipoprotein Cholesterol Treatment Target Achievement in Patients with Myocardial Infarction, Percutaneous Coronary Intervention, or Stroke in Hong Kong
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1 Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
2 School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
3 Digital and Data Innovation, AstraZeneca Global R&D (China) Co, Ltd, 200000 Shanghai, China
4 School of Nursing, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
5 Laboratory of Data Discovery for Health, Hong Kong Science Park, Sha Tin, Hong Kong SAR, China
6 Aston Pharmacy School, Aston University, B4 7ET Birmingham, UK
7 Division of Cardiology, Department of Medicine, University of Hong Kong, Hong Kong SAR, China
8 Department of Pharmacy, The University of Hong Kong-Shenzhen Hospital, 518000 Shenzhen, GuangDong, China
9 The University of Hong Kong Shenzhen Institute of Research and Innovation, 518000 Shenzhen, GuangDong, China
*Correspondence: (Esther W Chan)
Academic Editors: Gianluca Rigatelli and Arrigo F.G. Cicero
Rev. Cardiovasc. Med. 2022, 23(10), 327;
Submitted: 2 May 2022 | Revised: 11 August 2022 | Accepted: 22 August 2022 | Published: 26 September 2022
(This article belongs to the Special Issue Lipids and Cardiovascular Risks)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Background: Elevated concentrations of low-density lipoprotein cholesterol (LDL-C) are an important cause of recurrent cardiovascular events. This study aimed to describe the distribution and achieved concentrations of LDL-C among patients with myocardial infarction (MI), percutaneous coronary intervention (PCI), stroke, or transient ischaemic attack (TIA) in Hong Kong. Methods: Patients with a lipid test from a public hospital were identified from the Clinical Database and Analysis Reporting System of the Hong Kong Hospital Authority. Among patients with an inpatient hospitalization for MI, PCI, stroke or TIA, between 2003 to 2016, the distribution of LDL-C levels and the number (%) of patients achieving an absolute concentration of LDL-C <1.8 mmol/L at baseline (in-hospital) and during 12 months after hospital discharge were described. Results: A total of 18417 patients were included (mean [SD] age, 70.0 [12.9] years; male, 60.3%), of which 3637 had MI, 4096 had PCI, and 10684 had stroke or TIA. At hospital discharge 12082 (65.6%) patients were prescribed statins, 690 (3.7%) were prescribed nonstatins, and 1849 (10.0%) achieved an LDL-C <1.8 mmol/L. Overall, 5654 (30.7%) patients did not have LDL-C result available within 12 months of discharge (MI, 605 [16.6%]; PCI, 432 [10.5%]; stroke or TIA, 4617 [43.2%]). Among the overall cohort, 4591 (24.9%) patients achieved an LDL-C <1.8 mmol/L during 12 months of follow-up (MI, 1288 [35.4%]; PCI, 1542 [37.6%]; stroke or TIA, 1761 [16.5%]). Improvements in achieved LDL-C were observed over time with a mean LDL-C 2.64 (0.92) mmol/L and 20.0% of patients achieving an LDL-C <1.8 mmol/L in 2003 as compared with a mean LDL-C 1.86 (0.70) mmol/L and 53.9% of patients achieving an LDL-C <1.8 mmol/L in 2016. Conclusions: In this single centre cohort study from Hong Kong, nearly half of patients with MI, PCI, or stroke in 2016 appear to qualify for intensification of lipid-modifying drug treatment in order to achieve a treatment goal of LDL-C <1.8 mmol/L. Further research is required in Hong Kong to assess contemporary management of LDL-C in a larger group of patients with established atherosclerotic cardiovascular disease.

low-density lipoprotein cholesterol
myocardial infarction
transient ischaemic attack
percutaneous coronary intervention
secondary prevention
Hong Kong
RS190135/Amgen Asia Holdings Limited, Hong Kong SAR, China
Fig. 1.
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