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Background: The LDL cholesterol (LDL-C) goal achievement in patients with coronary heart disease (CHD), as recommended by Guidelines, is generally low. Objective: We sought to compare the outcomes of two different strategies in chronic CHD patients remitted from general practioners to an out-of-hospital cardiology practice, one conventional follow-up (CFU) and one structured follow-up (SFU). Methods: All 302 consecutive patients with angiographically documented CHD seen during one year were reviewed and lipid levels after one cardiologist consultation were collected retrospectively the following year (CFU). During the two succeeding years, all 464 patients with this diagnosis were followed prospectively in the cardiology practice in a simple, structured manner until LDL-C ≤2.0 mmol/L was reached, using more potent statins and with the addition of ezetimibe if baseline LDL-C was ≥2.5 mmol/L or if a potent statin did not reduce the LDL-C level to ≤2.0 mmol/L (SFU). Results: At baseline, only 1/3 of all patients had LDL-C ≤2 mmol/L. After CFU this increased to 59%, while following the SFU programme 90% reached this goal. The mean LDL-C levels decreased from 2.4 to 2.2 mmol/L after CFU and from 2.5 to 1.8 mmol/L in the SFU group, all differences significant at p<0.001. Conclusion: A simple structured follow-up programme in out-of-hospital cardiology practice can bring 90 % of these patients to a LDL-C level of 2.0 mmol/L or lower, which was the goal at the time of start of this programme, with the use of more potent statins and the addition of ezetimibe when needed

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