Poor achievement of lipid targets after acute coronary syndrome: what can we improve?

Overcoming problems that impede the delivery of evidence‐based care is needed to bridge gaps between science and improving health

The benefits of lipid‐lowering therapy for the secondary prevention of atherosclerotic cardiovascular disease, including its effect on mortality, have been recognised since the publication of the seminal 4S trial in 1994.1 Recent clinical trials of novel lipid‐lowering therapies in people taking statins have found that the lower the low‐density lipoprotein cholesterol (LDL‐C) level achieved, the lower the risk of adverse cardiovascular events.2 It is beyond doubt that people at high risk of adverse cardiovascular events, including those with a history of acute coronary syndrome, benefit most from aggressive lipid‐lowering therapy. Accordingly, the recommended LDL‐C targets are lowest for such people, and have been continually reduced in international guidelines over time.3