TY - JOUR
TI - EU-Wide Cross-Sectional Observational Study of Lipid-Modifying Therapy
Use in Secondary and Primary Care: the DA VINCI study
AU - Ray, Kausik K.
AU - Molemans, Bart
AU - Schoonen, W. Marieke
AU - Giovas,
AU - Periklis
AU - Bray, Sarah
AU - Kiru, Gaia
AU - Murphy, Jennifer
AU - Banach,
AU - Maciej
AU - De Servi, Stefano
AU - Gaita, Dan
AU - Gouni-Berthold, Ioanna
AU - and Hovingh, G. Kees
AU - Jozwiak, Jacek J.
AU - Jukema, J. Wouter and
AU - Kiss, Robert Gabor
AU - Kownator, Serge
AU - Iversen, Helle K.
AU - Maher,
AU - Vincent
AU - Masana, Luis
AU - Parkhomenko, Alexander
AU - Peeters, Andre
AU - and Clifford, Piers
AU - Raslova, Katarina
AU - Siostrzonek, Peter and
AU - Romeo, Stefano
AU - Tousoulis, Dimitrios
AU - Vlachopoulos, Charalambos
AU - and Vrablik, Michal
AU - Catapano, Alberico L.
AU - Poulter, Neil R. and
AU - DA VINCI study
JO - European Journal of Preventive Cardiology
PY - 2021
VL - 28
TODO - 11
SP - 1279-1289
PB - Oxford University Press
SN - 2047-4873, 2047-4881
TODO - 10.1093/eurjpc/zwaa047
TODO - Registry; Guidelines; Cholesterol; Statins; Lipids
TODO - Aims To provide contemporary data on the implementation of European
guideline recommendations for lipid-lowering therapies (LLTs) across
different settings and populations and how this impacts low-density
lipoprotein cholesterol (LDL-C) goal achievement.
Methods and results An 18 country, cross-sectional, observational study
of patients prescribed LLT for primary or secondary prevention in
primary or secondary care across Europe. Between June 2017 and November
2018, data were collected at a single visit, including LLT in the
preceding 12 months and most recent LDL-C. Primary outcome was the
achievement of risk-based 2016 European Society of Cardiology
(ESC)/European Atherosclerosis Society (EAS) LDL-C goal while receiving
stabilized LLT; 2019 goal achievement was also assessed. Overall, 5888
patients (3000 primary and 2888 secondary prevention patients) were
enrolled; 54% [95% confidence interval (CI) 52-56] achieved their
risk-based 2016 goal and 33% (95% CI 32-35) achieved their risk-based
2019 goal. High-intensity statin monotherapy was used in 20% and 38%
of very high-risk primary and secondary prevention patients,
respectively. Corresponding 2016 goal attainment was 22% and 45% (17%
and 22% for 2019 goals) for very high-risk primary and secondary
prevention patients, respectively. Use of moderate-high-intensity
statins in combination with ezetimibe (9%), or any LLT with PCSK9
inhibitors (1%), was low; corresponding 2016 and 2019 goal attainment
was 53% and 20% (ezetimibe combination), and 67% and 58% (PCSK9i
combination).
Conclusion Gaps between clinical guidelines and clinical practice for
lipid management across Europe persist, which will be exacerbated by the
2019 guidelines. Even with optimized statins, greater utilization of
non-statin LLT is likely needed to reduce these gaps for patients at
highest risk.
ER -