Cardiovascular Outcomes in Response to Achieved LDL-C Levels After PCI in ACS and CCS

BACKGROUND: Acute coronary syndrome (ACS) exhibits greater risks of recurrent atherosclerotic cardiovascular disease compared to chronic coronary syndrome (CCS), suggesting the need for more intensified preventive management, including low-density lipoprotein cholesterol (LDL-C) control. However, current guidelines advocate the "same" LDL-C goals in both ACS and CCS. OBJECTIVES: The authors aimed to compare cardiovascular outcomes following attainment of guideline-recommended LDL-C control between ACS and CCS. METHODS: This multicenter retrospective observational study (ACTION-LDLC; jRCT 1050260064) analyzed 2,560 Japanese patients with coronary artery disease (ACS/CCS = 1,682/878). Risk of major adverse cardiovascular events (MACE; cardiac-caused death + nonfatal MI + coronary revascularization in nonculprit segments) was compared according to achieved LDL-C levels 8 weeks after percutaneous coronary intervention (