Low-density lipoprotein cholesterol (LDL-C) monitoring in the first year after coronary artery disease diagnosis was strongly linked to fewer major adverse cardiovascular events (MACE) and lower all-cause mortality. The findings were presented at the European Society of Cardiology Congress 2025.

Secondary prevention is a cornerstone of managing coronary artery disease, yet real-world practice often falls short. The DISCOVER-LDL registry analyzed 76,264 patients from 2015 to 2022, including 58,184 with chronic coronary syndromes and 16,813 with acute coronary syndromes.

Patients who never had LDL-C checked in the first year experienced significantly higher rates of MACE and mortality compared with those tested once or multiple times (p trend <0.001 for both). The protective effect of more frequent monitoring was consistent across socioeconomic groups and ethnicities, with no significant interaction by either factor. White patients had higher raw event rates than non-white patients, but this did not modify the impact of LDL-C checks.

Similar patterns were seen for statin prescription and dosing at discharge, with less intensive use associated with worse outcomes.

These results highlight the importance of consistent lipid monitoring and optimal statin therapy in patients with coronary artery disease, regardless of socioeconomic background or ethnicity. Routine assessment of LDL-C in the first year may be a simple, actionable step to reduce cardiovascular events and improve survival.