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16 Treatment intensity of lipid lowering therapy in high- and very high-risk patients for the prevention of cardiovascular events – baseline characteristics from the Irish cohort of the multinational, observational Santorini study

Heart (British Cardiac Society), 2023, Vol.109 (Suppl 6), p.A18-A19 [Peer Reviewed Journal]

2023 Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ. ;ISSN: 1355-6037 ;EISSN: 1468-201X ;DOI: 10.1136/heartjnl-2023-ICS.16

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  • Title:
    16 Treatment intensity of lipid lowering therapy in high- and very high-risk patients for the prevention of cardiovascular events – baseline characteristics from the Irish cohort of the multinational, observational Santorini study
  • Author: Rai, H ; Coughlan, J J ; Fitzgerald, S ; Sheahan, R ; Murphy, R ; McFadden, E ; Nolan, D ; Byrne, R A
  • Subjects: Clinical medicine ; Observational studies
  • Is Part Of: Heart (British Cardiac Society), 2023, Vol.109 (Suppl 6), p.A18-A19
  • Description: IntroductionMore stringent goals for low-density lipoprotein cholesterol (LDL-C) are recommended for patients with high and very high cardiovascular (CV) risk according to 2019 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guidelines. Real-world studies in Europe have previously demonstrated suboptimal achievement these LDL-C goals. Treatment of High and Very high riSk dyslipidemic pAtients for the PreveNTion of CardiOvasculaR Events in Europe – a MultInatioNal ObservatIonal Study (SANTORINI) is a European observational study conducted in 14 European countries. It aimed to assess whether the management of high- and very high-risk patients in clinical practice matches the treatment recommendations in the 2019 ESC/EAS guidelines (Clinicaltrials.gov identifier: NCT04271280).MethodsPatients aged ≥18 years assessed as being at high or very high cardiovascular risk and requiring LLT were recruited at 6 investigational sites in Ireland, across primary and secondary care settings, and enrolled in the SANTORINI study. The present analysis focuses on baseline patient characteristics, medical history, current lipid lowering therapy (LLT) and concomitant medications of these patients.ResultsA total of 100 patients were recruited from May 2020 to Jan 2021. The majority of these cases were classified as very high-risk (65%); 52% cases were classified based on clinical experience, with 47% classified as per ESC/EAS guidelines. Overall, 19% of cases were not receiving any LLT at baseline and 74% were receiving LLT-monotherapy (73% on statin monotherapy, 1% on other LLT-monotherapy). Combination therapy with a statin plus ezetimibe was used in 5% of patients and other LLT combinations were used in 2% of patients. Amongst high-risk cases receiving statin monotherapy, 50% were on a high intensity regimen. In the very high-risk group, 53.2% of cases were on a high intensity statin monotherapy regimen. Mean LDL-C levels at baseline in the total cohort was 2.08±0.96 mmol/L, with lower values in very high-risk cases as compared to high-risk cases (1.90±0.85 and 2.39±1.05 mmol/L respectively). Overall, at enrolment 66% of cases were not at their ESC/EAS guideline defined LDL-C goal (69% amongst the high-risk cases and 64% amongst the very high-risk cases).ConclusionsIn the current analysis, we found that ESC/EAS guidelines are not the most frequently used tool for risk classification (52% cases were classified using clinical experience). Mean LDL-C levels both in high and very high-risk patients were higher than the recommended goals and the usage of combination LLT therapy and high intensity statin monotherapy was low. The proportion of patients who attained LDL-C goals at enrolment was also very low. It appears that a majority of high and very high-risk patients are currently not treated to target LDL in routine clinical practice in Ireland.
  • Publisher: London: BMJ Publishing Group LTD
  • Language: English
  • Identifier: ISSN: 1355-6037
    EISSN: 1468-201X
    DOI: 10.1136/heartjnl-2023-ICS.16
  • Source: ProQuest Central
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