Improving Outcomes for People with Post-Acute Coronary Syndrome

Published on: April 27, 2023


Asian man lifting a hand weight
Sanofi is partnering with international experts & clinicians as part of the ACS EuroPath project to help optimize lipid management in patients after acute coronary syndrome (ACS).

Acute coronary syndrome (ACS) is a term used to describe a range of conditions associated with sudden, reduced blood flow to the heart. About 1 in 3 adults who survive a heart attack or stroke may experience another CV event within 4 years which means they are at a greater risk of ACS, including heart attack, unstable angina, and other CV events.1

ACS is a major cause of death & illness worldwide and post-ACS patients are at an even higher risk of further cardiovascular events, despite the availability of treatments.2

Assessing lipid management across Europe 

Since 2018, Sanofi has developed and supported the ACS EuroPath project, to identify and address the barriers to optimal lipid management in post-ACS patients.  

We work together to close the gap between clinical practice and the recommended European approach,2 and to increase achievement of the low-density lipoprotein-cholesterol (LDL-C) goals recommended for patients after ACS.  

  • Wave 1: Cardiologist Survey – To assess post-ACS lipid management and provide insights into aligning care closer to the European guidelines

Survey insights 

The cardiologist survey of 2,775 ACS patients in routine care found that:

  • 93% of patients received lipid-lowering therapy (LLT) during hospitalization, but  

  • a third (34%) did not receive high-intensity statin therapy at discharge  

  • the 75% of patients who were not at LDL-C goal after first follow-up did not receive any add-on lipid-lowering treatment  

These findings led to the development of the Wave 2 self-assessment tool.3

  • Wave 2:  

    • Self-Assessment Tool – Co-created with healthcare professionals (HCPs), to evaluate current clinical practice against current European guidelines. To identify strengths and weaknesses and support HCPs in optimizing post-ACS lipid management

    • Country Pathway Models – Concrete European examples of ACS lipid management optimization with good patient outcomes, that could be replicated to help optimize post-ACS lipid management

  • Wave 3: Additional General Practitioner (GP) & ACS Patient Surveys – To build on initial cardiologists’ insights. Based on survey results, international experts and clinicians identified areas of improvement and generated prototype solutions to address the areas2    

Identifying and prioritizing areas for improvement  

Eight country pathway models were identified building on previous initiatives that could be replicated across Europe to help optimize post-ACS lipid management.  

These models have been used in Austria, Belgium, France, Italy, The Netherlands, Spain, and Sweden, with each country seeing a marked improvement in patient outcomes. For example, in the Netherlands, the PENELOPE protocol, an ESC-guideline-based algorithm, helped 99% of very high-risk ACS patients reach the LDL-C goal 12 weeks post-acute event.4  

Five key areas of improvement were identified based on the cardiologist, GP, and ACS patient surveys:  

  1. Inappropriate treatment prescribed at discharge  

  1. Lack of lipid guidance in the discharge letter  

  1. Inadequate LLT optimization 

  1. Gaps in guideline knowledge and lack of referral practices for GPs 

  1. Patients’ concerns about lipid management 

ACS EuroPath: A blueprint for future optimization 

We are now focusing on further optimizing lipid management in post-ACS patients through the development and implementation of the two solutions identified through the earlier waves, and an additional cardiologist survey conducted more recently. The results will be published in due course.  

“ACS EuroPath reflects our 60-year commitment to the CV community” said Maja Bujas-Bobanovic, Global Medical Franchise Head, Sanofi General Medicines. “Sanofi is dedicated to improving post-ACS patient management beyond medicines with a holistic approach to care. We hope that ACS EuroPath serves as a blueprint for the future optimization of ACS care.”  


Explore more

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The ACS EuroPath project: Helping to optimize lipid management in patients after acute coronary syndrome (ACS)


  1. Bhatt D.L., et al. (2010) Comparative determinants of 4-year cardiovascular event rates in stable outpatients at risk of or with atherothrombosis. JAMA 304:1350; doi: 10.1001/jama.2010.1322 
  2. Landmesser U., et al. (2020) Lipid-lowering therapy and low-density lipoprotein cholesterol goal achievement in patients with acute coronary syndromes: The ACS patient pathway project. Atherosclerosis Supplements 42:e49; doi: 10.1016/j.atherosclerosissup.2021.01.009 
  3. Sionis A., et al. (2020) Improving lipid management in patients with acute coronary syndrome: The ACS Lipid EuroPath tool. Atherosclerosis Supplements 42:e65; doi: 10.1016/j.atherosclerosissup.2021.01.011 
  4. Alings M., et al. (2020) Implementation of clinical practices and pathways optimizing ACS patients lipid management: Focus on eight European initiatives. Atherosclerosis Supplements 42:e59; doi: 10.1016/j.atherosclerosissup.2021.01.010 
MAT-GLB-2205598 v3.0 01/2023