Lipid-lowering therapy use in primary and secondary care in Central and Eastern Europe: DA VINCI observational study.

Abstract

BACKGROUND AND AIMS\nCentral and Eastern Europe (CEE) is a largely understudied region, despite having the highest cardiovascular disease mortality in Europe. This analysis aimed to assess the proportion of patients in CEE who achieved their LDL-C goals based on individual cardiovascular risk recommended by the 2016 and 2019 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guidelines.\n\n\nMETHODS\nThe DA VINCI study was a cross-sectional observational study of primary and secondary prevention patients receiving lipid-lowering therapy across Europe between June 2017 and November 2018.\n\n\nRESULTS\nIn total, 2154 patients were enrolled from the Czech Republic (n\xa0=\xa0509), Hungary (n\xa0=\xa0319), Poland (n\xa0=\xa0460), Romania (n\xa0=\xa0259), Slovakia (n\xa0=\xa0123) and Ukraine (n\xa0=\xa0484). At LDL-C measurement, most patients were on either moderate- or high-intensity statin monotherapy (53% and 32%, respectively). Despite this, only 44% of patients achieved risk-based LDL-C goals recommended by the 2016 ESC/EAS guidelines, ranging from 21% in Ukraine to 50% in Hungary and Romania. Only 24% of patients overall achieved the risk-based LDL-C goals recommended by the 2019 ESC/EAS guidelines, ranging from 11% in Ukraine to 32% in Poland.\n\n\nCONCLUSIONS\nAmong patients receiving lipid-lowering therapy, more than half did not achieve their 2016 LDL-C goals. In one of the first comparative analyses evaluating 2019 risk-based goal attainment among countries in CEE, three-quarters of patients did not meet their 2019 LDL-C goals, highlighting a significant gap between guidelines and clinical practice for lipid management in CEE.