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Introduction Ischaemic Heart Disease (IHD) is a major global health burden, the leading cause of death worldwide and the primary cause of premature death in the UK. Therefore, the importance of high-quality secondary prevention is paramount to reduce mortality and subsequent cardiac events. The cause of IHD are multiple, being both non-modifiable (age, gender) and modifiable (smoking and co-morbidities such as hypertension, diabetes, hypercholesterolaemia and obesity).Recognising this, the European Society of Cardiology (ESC) developed a guideline for risk factor control with therapeutic targets, including weight, diabetic and blood pressure control, as well as low-density lipoprotein (LDL) reduction and smoking cessation.In light of recent pressures on healthcare services, our aim was to evaluate the extent to which these therapeutic targets are being achieved in a contemporary population of patients with IHD, treated at a tertiary cardiac facility.Method We retrospectively analysed data of 50 patients who had Percutaneous Coronary Intervention (PCI) and 50 patients who had Coronary Artery Bypass Grafting (CABG) between 1 st and 31st January 2023 at the Essex Cardiothoracic Centre (CTC). Baseline modifiable and non-modifiable risk factors were recorded for each patient and re-checked at 6 months post-discharge to assess if ESC targets were met.Results 100 patient records were included in the final analysis, with 50% of each group being elective and 50% being acute presentations ( figure 1). The mean age was 67.53±11.13 years, 87% were male, 67% had hypertension, 30% had diabetes, 32% had hypercholesterolaemia, 82% were overweight (Body Mass Index/BMI ≥ 25 kg/m2), 15% were smokers, and 28% had a history of previous myocardial infarction (table 1).Abstract 7-028 Figure 1Breakdown of the patient cohortAbstract 7-028 Table 1Baseline characteristics Characteristic Cohort of IHD Patients (n = 100) Age (years) 67.53±11.13 Male sex 87 (87%) Hypertension 67 (67%) Diabetes mellitus 30 (30%) Hypercholesterolaemia 32 (32%) Overweight 82 (82%) Current smoker 15 (15%) Previous myocardial infarction 28 (28%) Numbers are total (%) or mean ± standard deviationOverall, 83% of the cohort underwent re-assessment of all their modifiable risk factors. There was no significant change in LDL from baseline to follow-up, 2.86±1.66 to 2.42±2.10 (p=0.057). 61% of patients saw a reduction in LDL with the average change being -6.7%. Despite this, only 15% of the cohort met the ESC target at follow-up.A similar pattern was seen with the Glycosylated Haemoglobin (HbA1c), with a small numerical reduction from 58.27±18.24 to 54.97±13.49 (p=0.731), and 43.3% of the cohort meeting the ESC target at follow-up.The proportion of patients still smoking reduced from 15% to 12% from baseline to follow-up (p=0.533), with only 3 patients completely stopping. 82% were overweight at baseline, dropping to 62% at follow-up (p<0.05), with an average weight change of -1.3% in this group. The proportion of patients meeting the ESC Blood Pressure target increased from 31% to 48.4% (p=<0.05).Abstract 7-028 Table 2Summary of the proportion of patients meeting the ESC targets at baseline and follow-up Risk factors ESC Target Baseline Follow-up Smoking Cessation N/A 3 (20.00) Overweight (BMI ≥ 25 kg/m2) 5–10% weight loss N/A 19 (27.14) Hypertension (mmHg) BP < 130/80 31 (31.00) 44 (48.35) Diabetes (mmol/mol) HbA1c < 53 14 (46.67) 13 (43.33) Hypercholesterolaemia (mmol/L) LDL < 1.4 10 (10.31) 14 (15.05) Numbers are total (%) Conclusion Adherence to the evidence-based ESC guideline targets was poor, highlighting the need for more robust secondary prevention implementation post-discharge. Essex CTC is currently setting up a dedicated cardiovascular risk modification service to improve this unmet need, after which we will re-evaluate.