OBJECTIVES: Describe lipid-lowering therapy (LLT) treatment patterns in post-MI patients and adherence to 2019 ESC/EAS dyslipidemias guidelines.

METHODS: A cross-sectional survey was conducted in France, Germany, Italy, Netherlands, Spain, and United Kingdom (UK). A stratified sample of 60 physicians (cardiologists and general practitioners [GPs]) were surveyed in each country.

RESULTS: Of 360 physicians surveyed, 233 (64.7%) were secondary care cardiologists and 127 (35.3%) were primary care physicians (PCPs). 13.5% of cardiologists and 18.9% of PCPs reviewed LLT for all patients within 12 weeks of discharge after MI. 82.0% of cardiologists and 55.1% of PCPs stated that they consulted ESC/EAS guidelines, 42.9% of cardiologists and 55.1% of PCPs consulted national guidelines. Most physicians (86.9%) used LDL-C to assess lipid profile. Total cholesterol was mostly used in the UK, where 80.0% of GPs used that measure. For patients not achieving recommended lipid levels at 12 weeks, 90.6% of cardiologists would change LLT regimen immediately, 7.6% would wait longer, and 1.8% would take no action. Among PCPs, 51.6% would change LLT regimen immediately, 47.6% would wait longer, and 0.8% would take no action. Evaluating fictitious cases of post-MI patients whose LDL-C target recommended by ESC/EAS guidelines could not be reached using statins and ezetimibe, 23.0% of cardiologists and 6.3% of PCPs indicated that they would prescribe PCSK9 inhibitors.

CONCLUSIONS: Less than one fifth of physicians follow the recommendations of ESC/EAS guidelines and review all post-MI patients in their care within 12 weeks of discharge. When LDL-C goals are not reached, almost all cardiologists and approximately half of PCPs would change LLT. A small proportion of physicians use intensive LLT with PCSK9 inhibitors for post-MI patients, as recommended by ESC/EAS guidelines. These data suggest that education of physicians treating MI patients may be warranted.