OBJECTIVES: The objective of this study was to evaluate attainment of goal/normal lipid levels and predictors thereof following lipid modifying therapy (LMT). METHODS: Using CSD LPD database we identified patients age 18+  who initiated LMT between January 1, 2004-October 1, 2006, had a complete lipid profile (LDL-C, HDL-C and TG) 1 year pre and post index date and continued LMT for ≥ 9 months. High risk population was classified as those with CHD, diabetes or 10-year CHD risk>20%. Guidelines recommended by the current European Society of Cardiology were used to define threshold levels for elevated LDL-C, low HDL-C and elevated TGs. RESULTS: Among 524 patients (63% high risk), 93% had elevated LDL-C, 22% had low HDL-C and 62% had elevated TGs before therapy. Additionally, 67% experienced low HDL-C and/or elevated TG irrespective of LDL-C levels. Post therapy (93% on statins), 53% had elevated LDL-C (48% among high risk), 25% had low HDL-C (26% among high risk) and 43% had elevated TGs (39% among high risk). Low HDL-C and/or elevated TG were observed among 54% (52% among high risk). Obesity, presence of diabetes and lower baseline LDL-C were associated with better LDL-C goal attainment while attainment of normal TG level was associated with presence of hypertension and lower baseline TG.  Patients with higher baseline HDL-C and older female patients were more likely to attain HDL-C normal level, while female patients with CHD risk>20% were less likely to reach HDL-C normal level. CONCLUSIONS: In this longitudinal study of Italian patients, following therapy (where statins were primarily urilized), additional 40% of patients achieved LDL-C goal and additional 19% reached normal triglyceride levels, while no improvement was observed in HDL-C levels where additional 3% had low HDL-C. In addition to baseline lipid levels, certain CV risk factors were strong predictors for goal/normal level attainment of each lipid parameter.