EU-Wi<i>d</i>e Cross-Section<i>a</i>l Obser<i>v</i>at<i>i</i>o<i>n</i>al Study of Lipid-Modifying Therapy Use in Se<i>c</i>ondary and Pr<i>i</i>mary Care: the DA VINCI study
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Abstract
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.
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The record
- Venue
- European Journal of Preventive Cardiology
- Topic
- Lipoproteins and Cardiovascular Health
- Field
- Medicine
- Canadian institutions
- —
- Funders
- Netherlands Heart InstituteNIHR Imperial Biomedical Research CentreAbbott VascularEsperion TherapeuticsNovo NordiskTeva Pharmaceutical IndustriesDepartment of Health and Social CareBritish Heart FoundationAmryt PharmaAllerganAstraZenecaAmarin CorporationRegeneron PharmaceuticalsMylanIonis PharmaceuticalsValeant Pharmaceuticals InternationalBoston Scientific CorporationAbbott LaboratoriesNational Institute for Health and Care ResearchMedicines CompanyDaiichi Sankyo EuropeServierGilead SciencesCelgeneBristol-Myers SquibbEli Lilly and CompanyAmgenPfizerEuropean CommissionKowa CompanySanofi
- Keywords
- MedicineSection (typography)Library scienceHumanities
- Has abstract in OpenAlex
- yes