Rapid Escalation of LipiD Lowering Therapy to Reduce RecUrrent Cardiovascular Event

Rapid Escalation of LipiD Lowering Therapy to Reduce RecUrrent Cardiovascular Event (REDUCE) : All Comers Study

Hyperlipidaemia especially elevation of low-density lipoprotein cholesterol (LDL-C) is known to be the main contributor to the development of atherosclerotic cardiovascular disease (ASCVD).

Lowering LDL-C have been shown to reduce the risk of ASCVD2,3. Both the American Heart Association (AHA) and the European Society of Cardiology (ESC) advocated aggressive LDL-C target with statin being the first-line lipid-lowering therapy (LLT). However, a significant portion of patients did not attain their LDL-C goal in our locality. Statin no adherence, low uptake of adjuvant non-statin LLT, and therapeutic inertia are few potential causes for not achieving the LDL-C target. ESC recommends repeating blood test in 6-8 weeks after addition or alternation of LLT, but this recommendation was not routinely followed in current local practice due to resources constrain.

This registry therefore aims to investigate the strategy of frequent monitoring of LDL-C and titration of LLT in achieving LDL-C treatment target at a dedicated specialist clinic.

Inclusion Criteria:

• Age >18
• (Cohort 1) Diagnosis of acute coronary syndrome due to atherosclerotic coronary artery disease
• (Cohort 2) Diagnosis of chronic coronary syndrome due to atherosclerotic coronary artery disease

Exclusion Criteria:

• Inability to provide valid consent by the patient or his legal guardian
• Diagnosis of ACS due to other causes than atherosclerotic coronary artery disease.
• Psychiatric or severe neurological disorder, cirrhosis, or active malignancy leading to a life expectancy < 6 months.