Low-density lipoprotein cholesterol goal attainment in Germany: Results from the DA VINCI study

• Published in: Atherosclerosis plus Vol. 50; pp. 10 - 16
• Main Authors: Gouni-Berthold, Ioanna, Schaper, Frank, Schatz, Ulrike, Tabbert-Zitzler, Anja, Fraass, Uwe, Sauer, Sarah, Ray, Kausik K.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.12.2022; Elsevier
• Subjects: Cardiovascular risk; Cholesterol; Da Vinci; Dyslipidaemia; Full Length; Goal attainment; Guidelines; Statins; Cardiovascular risk; Dyslipidaemia; Da Vinci; Goal attainment; Cholesterol; Statins; Guidelines
• DOI: 10.1016/j.athplu.2022.07.024
• ISSN: 2667-0895; 2667-0909

Cardiovascular mortality is high in Germany. For patients with high or very high cardiovascular risk, the European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guidelines recommend intensive lipid lowering therapy (LLT). This study aimed to assess dyslipidaemia management and achievement of the ESC/EAS guideline-recommended low-density lipoprotein cholesterol (LDL-C) goals. This European 18-country, cross-sectional, observational DA VINCI study (EUPAS22075) collected data during a single visit between June 2017 and November 2018 and included LLT in the preceding 12 months and the patients' most recent LDL-C measurement. Achievement of the risk-based 2016 and 2019 ESC/EAS LDL-C goals while receiving stabilized LLT was assessed. Data from the German cohort are presented here. Seven German sites enrolled a total of 421 primary and secondary prevention patients, 327 were receiving stabilized LLT at the time of LDL-C measurement, i.e. statin monotherapy of high (16%; n = 53), moderate (49%; n = 160) or low (7%; n = 24) intensity, ezetimibe combination (18%; n = 58), proprotein convertase subtilisin/kexin type 9 antibody combination (3%; n = 9), and other LLT (7%; n = 23). The 2016 and 2019 risk-based LDL-C goals were attained by 46% (n = 149) and 28% (n = 92) of patients, respectively. There is a large gap between ESC/EAS recommendations and LDL-C goal achievement in routine clinical practice in high and very high-risk patients in Germany. Low-to-moderate-intensity statin monotherapy was the most frequently used LLT; use of high-intensity statins and combination therapy was limited. In addition to optimizing statin intensity, combination with non-statin LLT may be needed in most of these patients. [Display omitted] •This study evaluated lipid-lowering therapy use and dyslipidemia burden in Germany.•Attainment of LDL-C goals set by the 2016 and 2019 EAS/ESC guidelines was evaluated.•In Germany, more than half of patients did not achieve their 2016 LDL-C goals.•Attainment of the more stringent 2019 LDL-C goals was <30%.•Intense combination therapy in Germany could lead to better LDL-C goal attainment.