Clin Investig Arterioscler. 2026 Sep 17:500965. doi: 10.1016/j.arteri.2026.500965. Online ahead of print.
ABSTRACT
OBJECTIVES: The COVID-19 pandemic and the implementation of the 2019 ESC/EAS guidelines occurred concurrently and may have modified the clinical profile of patients with chronic coronary syndrome (CCS). The aim of this study was to evaluate changes in clinical characteristics, cardiovascular risk factors, coronary anatomy, and lipid control by comparing two distinct time periods.
METHODS: This multicentre cross-sectional study included 1,925 patients with CCS from the four healthcare areas of the province of Cáceres (Spain). Two periods were compared: the pre-pandemic period (up to 10 March 2020) and the period following the acute phase of the pandemic (from June 2020 to December 2025). Lipid control was assessed according to the 2016 ESC/EAS guidelines in the pre-pandemic cohort and the 2019 ESC/EAS guidelines in the post-pandemic cohort. Clinical variables, lipid profile, and coronary disease severity were analysed. Multivariable logistic regression models were used to assess achievement of LDL cholesterol <55mg/dL.
RESULTS: The post-pandemic cohort was younger (63.5 vs. 65.3 years; P=.001), with a lower prevalence of hypertension (53.4% vs. 63.7%; P<.001) and no differences in diabetes mellitus, but a higher prevalence of dyslipidaemia (76.9% vs. 67.3%; P<.001). A lower prevalence of renal impairment (15.5% vs. 22.6%; P<.001) and three-vessel coronary disease (17.0% vs. 25.3%; P<.001) was also observed. LDL cholesterol levels under treatment were lower in the post-pandemic period (57.5 vs. 67.6mg/dL; P<.001). The proportion of patients achieving LDL cholesterol targets of <70mg/dL and <55mg/dL was higher in the post-pandemic cohort. In multivariable analysis, this association remained significant after adjustment for major baseline clinical characteristics.
CONCLUSIONS: Patients with CCS evaluated after the acute phase of the pandemic were younger and exhibited lower anatomical and renal disease complexity, suggesting changes in the clinical profile of the population receiving cardiovascular care following the pandemic. In parallel, a significant improvement in lipid control was observed, probably related to greater intensification of lipid-lowering therapy and the implementation of more stringent treatment targets according to contemporary guidelines.
PMID:42754418 | DOI:10.1016/j.arteri.2026.500965