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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Ray, KK; Haq, I; Bilitou, A; Manu, MC; Burden, A; Aguiar, C; Arca, M; Connolly, DL; Eriksson, M; Ferrières, J; Laufs, U; Mostaza, JM; Nanchen, D; Rietzschel, E; Strandberg, T; Toplak, H; Visseren, FLJ; Catapano, AL, , SANTORINI, Study, Investigators.
Treatment gaps in the implementation of LDL cholesterol control among high- and very high-risk patients in Europe between 2020 and 2021: the multinational observational SANTORINI study.
Lancet Reg Health Eur. 2023; 29: 100624 Doi: 10.1016/j.lanepe.2023.100624 [OPEN ACCESS]
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Co-Autor*innen der Med Uni Graz
Toplak Hermann
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Abstract:
BACKGROUND: European data pre-2019 suggest statin monotherapy is the most common approach to lipid management for preventing cardiovascular (CV) events, resulting in only one-fifth of high- and very high-risk patients achieving the 2019 ESC/EAS recommended low-density lipoprotein cholesterol (LDL-C) goals. Whether the treatment landscape has evolved, or gaps persist remains of interest. METHODS: Baseline data are presented from SANTORINI, an observational, prospective study that documents the use of lipid-lowering therapies (LLTs) in patients ≥18 years at high or very high CV risk between 2020 and 2021 across primary and secondary care settings in 14 European countries. FINDINGS: Of 9602 enrolled patients, 9044 with complete data were included (mean age: 65.3 ± 10.9 years; 72.6% male). Physicians reported using 2019 ESC/EAS guidelines as a basis for CV risk classification in 52.0% (4706/9044) of patients (overall: high risk 29.2%; very high risk 70.8%). However, centrally re-assessed CV risk based on 2019 ESC/EAS guidelines suggested 6.5% (308/4706) and 91.0% (4284/4706) were high- and very high-risk patients, respectively. Overall, 21.8% of patients had no documented LLTs, 54.2% were receiving monotherapy and 24.0% combination LLT. Median (interquartile range [IQR]) LDL-C was 2.1 (1.6, 3.0) mmol/L (82 [60, 117] mg/dL), with 20.1% of patients achieving risk-based LDL-C goals as per the 2019 ESC/EAS guidelines. INTERPRETATION: At the time of study enrolment, 80% of high- and very high-risk patients failed to achieve 2019 ESC/EAS guidelines LDL-C goals. Contributory factors may include CV risk underestimation and underutilization of combination therapies. Further efforts are needed to achieve current guideline-recommended LDL-C goals. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04271280. FUNDING: This study is funded by Daiichi Sankyo Europe GmbH, Munich, Germany.

Find related publications in this database (Keywords)
Cardiovascular disease
LDL cholesterol
High cardiovascular risk
Lipid-lowering therapy
Real-world evidence
Cohort study
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