OBJECTIVES: To investigate lipid-modifying therapy (LMT) and LDL-C achievements in patients at very high cardiovascular (VHCV) risk using real-world data from general practitioners (GPs) in Italy.

METHODS: Retrospective analysis on Real World Data from IQVIA Italian Longitudinal Patient Database. Patients with an LDL-C measurement during the period 01 May 2016 - 30 April 2017 (Index Date) were selected and hierarchically classified into the following mutually exclusive VHCV risk groups: coronary artery disease (CAD), cerebrovascular disease (CVD), peripheral artery disease (PAD), and diabetes mellitus (DM). Cardiovascular risk factors were evaluated during the five-year period preceding the Index Date. LMT use during the six-month period preceeding the Index Date (included) and LDL-C goal attainment at the Index Date were assessed.

RESULTS: Total cohort was composed of 74,243 patients; of them, 21,469 (29%) were affected from CAD, 20,293 (27%) from CVD, 2,947 (4%) from PAD, and 29,534 (40%) from DM. Proportion of patients receiving an high potency statin, either alone or in combination, ranged from 3% for DM, to 20% for CAD, while proportion of patients receiving a standard potency statin, either alone or in combination, ranged from 40% for PAD to 53% for CAD. Patients who did not receive any LMT during the observed period accounted respectively for 21%, 42%, 52% and 50% in CAD, CVD, PAD and DM groups. For all the considered VHCV risk groups, around a 76% of patients have an LDL-c value above 70 mg/dL despite receiving a LMT treatment.

CONCLUSIONS: Despite known capacity of statins to lower LDL-C level, there is still a 39% of VHCV risk patients who did not receive any LMTs, or even receiving any LMTs at all, around 76% of patients have an LDL-c value not a target, suggesting that adherence to guidelines is still low.