Among 3,029 Mexican adults with chronic coronary syndrome (CCS) enrolled across ~50 centers between September 2024 and March 2025, the RESINCCRO registry found a striking paradox: despite 93.2% statin prescription rates, only 26.1% achieved the ESC-recommended LDL-C target of <55 mg/dL, with median LDL-C sitting at 70 mg/dL. Cardiometabolic burden was severe — 76% were overweight or obese, 69% hypertensive, 44% had type 2 diabetes, and 24.2% had chronic kidney disease. Cardiac rehabilitation participation was a mere 6.2%, and PCSK9 inhibitor use reached only 2.4%.
These findings expose a treatment-intensity gap that mirrors patterns seen globally but carries particular urgency in Latin American populations, where guideline adoption lags and access to advanced lipid-lowering agents like PCSK9 inhibitors remains limited. The registry's real-world design captures care actually delivered, not trial-optimized outcomes — making the LDL failure rate arguably more alarming than equivalent figures from randomized studies. The 60.3% obstructive epicardial disease rate and near-absent cardiac rehabilitation uptake signal systemic infrastructure deficits. For adult readers focused on longevity, this underscores that statin prescription alone is insufficient — combination therapy and structured rehabilitation dramatically reduce cardiovascular mortality. Critically, this is a preprint posted on medRxiv and has not yet undergone peer review; methodology and conclusions may be revised. The registry's cross-sectional, observational design also limits causal inference, but the sheer cohort size makes the prevention gaps difficult to dismiss.
