A clinical DSS was evaluated to determine whether it could influence LLT decisions after acute coronary syndrome (ACS). European Heart Journal – Digital Health reported findings from a pragmatic multinational cluster-randomized trial assessing the effect of mandatory DSS access on LLT intensity compared with SoC.

The study enrolled 1,139 adults across 42 hospital sites in the United Kingdom, Italy, and Spain. Participants had a median age of 62 years. Most had no prior cardiovascular disease (CVD) and were LLT-naïve at admission. The primary endpoint was the proportion receiving intensified monotherapy or initiated or escalated combination LLT by week 16 relative to pre-admission treatment.

The primary endpoint occurred in 71.7% of the DSS group and 65.7% of the SoC group (risk ratio [RR] 1.11; 95% confidence interval [CI] 0.92 to 1.33). Intensification of monotherapy occurred in 9.0% with DSS and 13.1% with SoC. Combination LLT initiation or escalation occurred in 61.6% with DSS and 50.6% with SoC. LDL-C goal attainment of less than 1.4 mmol/L reached 54.8% with DSS and 50.3% with SoC. Escalation of LLT before discharge reached 64.8% with DSS and 60.7% with SoC.

These findings show no change in overall intensification or LDL-C goal attainment with DSS use but suggest an early shift toward combination LLT that warrants further study.