Factors influencing LDL-c after acute coronary syndrome and effectiveness of intensive monitoring by teleconsultation: The TELEOBJECTIF cohort study.

Low-density lipoprotein cholesterol (LDL-c) plays a key role in the development and progression of atherosclerotic cardiovascular disease (ASCVD). Despite the availability of effective lipid-lowering treatments, patients who have experiencedan acute coronary syndrome (ACS) continue to face a high risk of recurrentcardiovascular events and mortality. Achieving the recommended LDL-c target of < 0.55 g/L in secondary cardiovascular prevention remains a significant challenge, with fewer than 30% of patients reaching this goal. To investigate the factors influencing LDL-c control after ACS and the effectiveness of intensive teleconsultation monitoring to control LDL-c, even in sub-groups where control is poorest. This bi-centric prospective cohort study conducted between December 2019 and December 2021 compared a group that received standard follow-up after an ACS with an interventional group that received regular follow-up by teleconsultation in addition of usual care to optimize lipid-lowering treatment. A subgroup analysis was carried out to examine the effect of teleconsultation in subpopulations known to be significantly associated with better or worse LDL-c control in the usual caregroup or described in the literature. Seven hundred and eighty-eight in the teleconsultation group. Baseline characteristics were similar between groups. In the usual care group, factors influencing lipid control included gender, diabetes, cardiology consultation, distance to the nearest cardiologist, social deprivation and initial LDL-c levels. Teleconsultation significantly improved LDL-c target attainment compared to usual care (74.7 vs. 26.6%, P < 0.001 with multivariate analysis OR 5.06 [4.21; 6.07]), particularly benefiting geographically and socially disadvantaged patients. Teleconsultation significantly improves lipid control in acute coronary syndrome patients compared to usual care. This universal intervention, particularly beneficial for geographically and socially disadvantaged patients, highlights the potential of telemedicine in enhancing cardiovascular management (Fig. 1). [ABSTRACT FROM AUTHOR]