{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T07:00:24Z","timestamp":1780470024419,"version":"3.54.1"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002336","name":"Daiichi Sankyo Company","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002336","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Contemporary registry data indicate that only 20%\u201325% of patients following acute myocardial infarction achieve guideline-recommended low-density lipoprotein cholesterol (LDL-C) values &amp;lt;1.4\u2005mmol\/L (55\u2005mg\/dL). The present study aims to evaluate the impact of early intensive therapy (potent statin\u2009+\u2009ezetimibe\u2009\u00b1\u2009bempedoic acid) on lipid control after myocardial infarction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a prospective, interventional, single-center study designed to assess the effectiveness of bempedoic acid in achieving LDL-C targets in patients following ST-elevation or non-ST-elevation myocardial infarction who remain insufficiently treated with atorvastatin plus ezetimibe. Patients not previously treated with lipid-lowering agents and presenting with admission LDL-C\u2009&amp;gt;\u20092.6\u2005mmol\/L (100\u2005mg\/dL) will be treated with atorvastatin (at least 40\u2005mg\/day or equivalent) plus ezetimibe (10\u2005mg\/day) for 6 weeks. Thereafter, the subgroup of patients failing to reach an LDL-C\u2009&amp;lt;\u20091.4\u2005mmol\/L (55\u2005mg\/dL) will be escalated to additive bempedoic acid (180\u2005mg\/day) for another 8 weeks. Those who reach the target will continue the aforementioned therapy. The primary endpoint is the proportion of patients who successfully achieve an LDL-C\u2009&amp;lt;\u20091.4\u2005mmol\/L (55\u2005mg\/dL) after 8 weeks of treatment with triple therapy. Secondary endpoints include the proportion of patients successfully reaching the target in the overall population and in the background medication group alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The results of this study will provide novel insights into post-infarction LDL-C control by evaluating the usefulness of an early intensive escalation oral lipid-lowering treatment strategy. Early intensive lipid-lowering triple oral therapy may facilitate the achievement of guideline-recommended LDL-C levels within the first 3 months after myocardial infarction compared with current clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration<\/jats:title>\n                    <jats:p>EudraCT 2022-003526-50<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1755590","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T06:01:04Z","timestamp":1780466464000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Early escalation of oral lipid-lowering therapy to achieve LDL-cholesterol targets in patients after myocardial infarction: study protocol for the prospective, open-label HAnnover ChOlesterol Lowering in Acute Coronary Syndrome trial"],"prefix":"10.3389","volume":"13","author":[{"given":"Andreas","family":"Sch\u00e4fer","sequence":"first","affiliation":[{"name":"Department of Cardiology and Angiology, Hannover Medical School","place":["Hannover, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anika","family":"Gro\u00dfhennig","sequence":"additional","affiliation":[{"name":"Institute of Biostatistics, Hannover Medical School","place":["Hannover, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonie","family":"Theis","sequence":"additional","affiliation":[{"name":"Institute of Biostatistics, Hannover Medical School","place":["Hannover, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Schindler","sequence":"additional","affiliation":[{"name":"Center for Clinical Trials, Hannover Medical School","place":["Hannover, 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