Pharmacist-Led Clinic Optimizes Lipid Therapy for Postacute Coronary Syndromes

Patients who have experienced an acute coronary syndrome (ACS), a group of heart conditions characterized by reduced or blocked blood flow to the heart muscle, require sustained management of underlying factors to reduce the risk of further disease and prevent life-threatening cardiac events. For example, almost 30% of deaths due to cardiovascular disease in the United Kingdom are attributed to raised cholesterol. However, every 1.0 mmol/L reduction in low-density lipoprotein (LDL)—a major risk factor for cardiovascular disease—is linked to a 23% reduction in major atherosclerotic events, highlighting an area of concern and a target area for risk reduction.¹

New data presented at the European Society of Cardiology 2025 Congress in Madrid, Spain, highlights the role for pharmacists in this risk reduction.

Role of Pharmacists in Achieving Lipid-Lowering Goals

High-intensity lipid-modifying therapies are often initiated to maintain secondary cardiovascular prevention targets. Despite the presence of established lipid guidelines for patients who have experienced or are at risk of ACS, many patients fail to achieve their target cholesterol goals. The gap between patients achieving and not achieving their goals continues to widen, necessitating enhanced intervention and therapy optimization. In this vein, clinical pharmacists play an essential role, as they are uniquely positioned to improve cholesterol management in lipid clinics, hospitals, and specialty pharmacies alike.^1,2

Pharmacists have a range of tools at their disposal to improve cholesterol management for patients with ACS. By thoroughly reviewing a patient’s medical history, they can gain insights into their historical lipid levels and past cardiac events. They are also critical in selecting the right lipid-lowering therapy for each patient, in addition to educating patients on adherence strategies and possible adverse effects. Research has demonstrated that these interventions can produce meaningful improvements in lipid parameters and increase the number of patients achieving their LDL goals, along with a noticeable decrease in clinical events.^1,2

Case Study Demonstrates Significant Lipid Reductions With Pharmacist Optimization

A new abstract presented during the European Society of Cardiology 2025 Congress in Madrid, Spain, demonstrates the critical benefit of pharmacist-led lipid optimization for secondary prevention in patients with ACS. The investigators established a pharmacist-led secondary prevention service covering ACS patients. Four clinics were conducted weekly, with 2 clinics occurring face-to-face and 2 clinics occurring via telephone reviews, each conducted by a trained clinical pharmacist. Lipid management was in accordance with current national guidelines and was optimized to the patient’s cardiovascular disease risk. The patients were reviewed in clinics, including going through the optimization of medications—such as high-intensity statins and injectable lipid-lowering therapy, if eligible—and post-intervention monitoring.²

In total, 552 patients with a mean age of 69 years were enrolled in the study, for which 527 (95%) were on statins and 538 (98%) were above the target of non-high-density lipoprotein (non-HDL) or 2.5 mmol/L (mean: 3.89 mmol/L). Following initial therapy optimization by cardiology services, 182 of 370 patients (49%) remained above their target goal. However, following further optimization in the specialty pharmacist-led clinic, there were significant reductions in total cholesterol and non-HDL to a mean of 2.49 mmol/L. After pharmacist optimization, 77 of 108 (71%) patients were at their target cholesterol levels (odds ratio = 2.40 [95% CI, 1.51–3.82]; P < .001). Furthermore, calculated LDL levels indicated a mean additional reduction of 0.95 mmol/L because of the pharmacist-led intervention.²

What Should Pharmacists Know?

The case study presented at ESC affirms that pharmacists are an indispensable partner in achieving cholesterol goals for patients with established risk for ACS. Pharmacists can drive meaningful reductions in LDL levels by effectively and honestly engaging with patients. As a trusted and front-facing health care provider that patients consistently interact with, they play the unique role of both listening to and understanding patients' concerns regarding their cardiovascular risk while providing educational resources and counseling.^1,2

Additionally, the results of this investigation warrant consideration of the establishment of pharmacist-led secondary prevention clinics for patients post-ACS. Pharmacists can facilitate conversations regarding lipid adherence and get an honest perspective of a patient’s lipid management strategies to help reduce the risk of developing further cardiovascular disease and life-threatening cardiac events, helping guide them toward more effective cardiovascular management.^1,2

REFERENCES

1. Ito MK. Role of the Pharmacist in Establishing Lipid Intervention Programs. ACCP Journals. 2012;23(9P2):41S-47S. doi:10.1592/phco.23.11.41S.32712

2. Hart M, Luvai A, Rees J, et al. Impact of a pharmacist-led clinic in optimising lipid therapy for post-acute coronary syndromes (ACS) in high risk cardiovascular patients. Presented: European Society of Cardiology Congress 2025. Presented August 31, 2025 in Madrid, Spain. Accessible Online: https://esc365.escardio.org/esc-congress/abstract?text=pharmacist&docType=All&days&page=1&vue=cards