{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T21:44:58Z","timestamp":1788471898318,"version":"build-2803163510"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T00:00:00Z","timestamp":1756252800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T00:00:00Z","timestamp":1756252800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100007653","name":"Universit\u00e4tsklinikum Jena","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007653","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Res Cardiol"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\u201cJena auf Ziel\u201d (\u201cJaZ\u201d) is a prospective cohort study in patients with ST-elevation myocardial infarction (STEMI). Early combination of a statin and ezetimibe was initiated on the day of admission and lipid-lowering therapy (LLT) was escalated during follow-up with bempedoic acid (BA) and PCSK9 inhibitors (PCSK9-I) to reach guideline-recommended LDL-cholesterol (LDL-C) levels. During the initial follow-up period of 12\u00a0months, all patients reached the recommended ESC\/EAS LDL-C target for very high-risk patients of\u2009&lt;\u200955\u00a0mg\/dL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twelve months after the index event, patients enrolled in \u201cJaZ\u201d had the option of either continuing with regular follow-ups in the outpatient lipid clinic of the university hospital Jena or transitioning to standard care by their general practitioners (GPs). Fifty-three patients (62%) stayed with the outpatient lipid clinic and 32 (38%) preferred treatment by their local GP. After 24\u00a0months, we analyzed differences in prescribed lipid-lowering drugs, LDL-C target attainment, LDL-C time on target, and major adverse cardiac events (MACEs\u2009=\u2009nonfatal ischemic cardiovascular events, admission for heart failure, nonfatal stroke) between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All 85 patients enrolled in the initial study were followed up for 24\u00a0months. The average LDL-C after 24\u00a0months was 1.47\u2009\u00b1\u20090.71\u00a0mmol\/L in the total study population. Fifty-one patients (60%) of the entire cohort were still on LDL-C target of 1.4\u00a0mmol\/L or below (outpatient lipid clinic group: 72.5% vs. GP group: 27.5%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.037). The average LDL-C in patients followed up in the outpatient lipid clinic was significantly lower compared to patients who were treated by GPs (1.2\u2009\u00b1\u20090.7\u00a0mmol\/L vs. 2.1\u2009\u00b1\u20091.04\u00a0mmol\/L;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Moreover, patients in the outpatient lipid clinic had a longer time on LDL-C targets compared to patients treated by GPs (82.4\u2009\u00b1\u200929.5% vs. 62.4\u2009\u00b1\u200936.6%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). The main cause of missed LDL-C targets was deprescribing of LLT by local GPs, surpassing non-adherence (2.1\u2009\u00b1\u20091.04\u00a0mmol\/L vs. LDL-C: 1.52\u2009\u00b1\u20090.53\u00a0mmol\/L;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Patients with MACE during follow-up were characterized by a shorter time on LDL-C targets compared to patients without MACE (58.1\u2009\u00b1\u200929.9% vs. 79.1\u2009\u00b1\u200928.1%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.048) and higher LDL-C levels at 24\u00a0months (2.04\u2009\u00b1\u20091.26\u00a0mmol\/L vs. 1.27\u2009\u00b1\u20090.72\u00a0mmol\/L;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this cohort of STEMI patients, a less intensive lipid-lowering strategy during a 2-year follow-up was associated with higher LDL-C levels and a higher incidence of MACE. Therefore, a regular follow-up in a specialized lipid outpatient clinic was superior to standard care treatment by general practitioners.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s00392-025-02736-y","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T08:17:19Z","timestamp":1756282639000},"page":"304-312","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Less intensive lipid-lowering therapy after ST-elevation myocardial infarction is associated with cardiovascular events: 2-year follow-up of \u201cJena auf Ziel\u201d"],"prefix":"10.1007","volume":"115","author":[{"given":"Franz","family":"Haertel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umidakhon","family":"Makhmudova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens-Arndt","family":"Geiling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernward","family":"Lauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"M\u00f6bius-Winkler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvia","family":"Otto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. 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The study was conducted in accordance with the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Informed consent was obtained from all subjects involved in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"The authors declare no competing interests.\u00a0OW received lecture fees and honoraria for advisory boards from AMGEN, Sanofi-Aventis, Novartis and Daiichi-Sankyo. All other authors declare no conflict of interest in regard to this manuscript.\u00a0","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}