# Target Achievements of Low-Density Lipoprotein Cholesterol, Blood Pressure, and Glucose in Patients with Diabetes after Acute Coronary Syndrome: Findings from the Chinese Cardiovascular Association Database – iHeart Project

## TL;DR

This study finds that diabetes patients after heart attacks have low rates of meeting cholesterol, blood pressure, and glucose targets, highlighting the need for better post-discharge monitoring.

## Contribution

The study identifies optimal monitoring strategies to improve metabolic target achievement in diabetic ACS patients.

## Key findings

- Only 16.6% of diabetic ACS patients met all three metabolic targets compared to 26.6% of non-diabetic patients.
- Early and frequent measurements within 12 months were linked to better target achievement in diabetic patients.
- Diabetic patients achieved LDL-C, BP, and HbA1c targets at 42.4%, 61.5%, and 43.7%, respectively.

## Abstract

To evaluate the achievement of metabolic risk factor targets and influencing factors in ACS patients with diabetes during the 12 months after discharge.

We retrospectively analyzed data from the Chinese Cardiovascular Association database-iHeart Project. Patients who were hospitalized with a diagnosis of ACS between 2014 and 2021 and who had at least one measurement record of LDL-C, BP, or HbA1c within 12 months after discharge were included. We further stratified patients by diabetes status and analyzed the correlation between clinical characteristics, measurement strategy, and achievement of targets.

Diabetes was identified in 1,027 (27.5%) of the eligible patients. The proportions of patients with diabetes achieving targets of LDL-C, BP, and HbA1c levels were 42.4%, 61.5%, and 43.7%, respectively. However, combined achievement rate was significantly lower in patients with diabetes than patients without diabetes (16.6% vs. 26.6%). Patients with diabetes who underwent the first measurement within three months or had ≥3 measurements within 12 months were positively associated with achieving combined targets.

The achievement of multifactorial targets among patients with ACS is suboptimal, particularly among patients with concomitant diabetes. The optimal measurement strategy post-discharge is essential for improving the comprehensive management of metabolic risk factors in ACS patients.