BACKGROUND: Cardiovascular diseases (CVD) are the leading cause of death worldwide, and the burden of CVD is higher in low and middle-income countries. Reduction of LDL-C levels is the cornerstone in risk reduction, but many high-risk patients are not achieving the recommended lipid goals, even in high income countries. 

AIM: To evaluate whether patients in the Brazilian public health system are reaching LDL-C goals after an acute myocardial infarction (AMI), including both the attainment to the LDL-C target levels and the percentage of LDL-C reduction. 

METHODS: This retrospective cohort explored the data of patients admitted with AMI between 2008 and 2015 in public hospitals in the city of Curitiba. To evaluate the attainment to LDL-C target, we used the last value registered in the database for each patient up to 2016. For those who had at least one LDL-C registered in the year before AMI, percentage of reduction was calculated. 

RESULTS: Of 7,066 patients admitted for AMI, 1,451 were followed in any out-patient setting and had at least one evaluation of LDL-C. Mean age was 60.8 ± 11.4 years and 35.8%, 35.2%, 21.5%, and 7.4% of patients had LDL-C levels >100, 70–100, 50–70, and <50 mg/dL, respectively. Of these, 377 patients also had at least one LDL-C evaluation before the AMI. The mean LDL-C concentrations were 128.1 and 93.3 mg/dL before and after AMI, with a mean reduction of 27.1% (34.8 mg/dL). LDL-C levels were reduced by more than 50% in only 18.3% of the cases. 

CONCLUSION: As in the rest of the world, the majority of high risk patients followed in the Brazilian public health system are not achieving adequate LDL-C levels after AMI.