20.500.12556/DiRROS-28735 Suboptimal management of hypercholesterolemia in countries with high or very high cardiovascular risk findings from the international DISCOVERY study Introduction: The 2019 ESC/EAS guidelines introduced stricter low-density lipoprotein cholesterol (LDL-C) targets, particularly for patients at high and very high cardiovascular (CV) risk. However, data on the implementation of these targets in real-world clinical practice—especially in countries with high/very high CV risk—remain limited. The DISCOVERY study aimed to assess LDL-C management, lipid-lowering therapy (LLT) use, and guideline adherence across multiple countries in Central and Eastern Europe and Central Asia. Methods: This prospective, observational, multicenter study enrolled adult patients with hypercholesterolemia (HCL) from 10 countries grouped into three regions. Data was collected at baseline and after 12 weeks of follow-up. LLT patterns, LDL-C levels, target attainment (both investigator-defined and 2019 ESC/EAS-recommended), and physician adherence to guidelines were analyzed. Results: A total of 6,447 patients were included; 53.2% were female, and the mean age was 60.5 ± 11.9 years. Most patients (66%) were in secondary prevention. At baseline, 36.8% had been treated with LLT. After the first visit, treatment was changed in 78% of patients, but only 42.4% received highintensity statins and 9.3% received statin-ezetimibe combinations at followup. LDL-C target achievement was poor: only 5.6% of patients met the guideline-recommended LDL-C goals, compared to 45.5% who met physician-defined targets. Among patients with ASCVD, only 3.3% achieved guideline LDL-C targets. The most significant gap was observed between guideline recommendations and physician-set LDL-C goals. No significant difference in LDL-C target attainment was observed between specialists and general practitioners. Discussion: The DISCOVERY study reveals suboptimal LDL-C control and low adherence to the 2019 ESC/EAS guidelines in routine practice across countries with high/very high CV risk. These findings highlight the urgent need for strategies to improve physician awareness, promote intensive LLT use, and close the gap between guidelines and clinical practice. A paradigm shift toward proactive LDL-C management is essential to reduce residual CV risk in these populations. LDL-C hypercholesterolemia lipid-lowering therapy ESC/EAS guidelines cardiovascular risk real-world evidence statins ezetimibe true false true Angleški jezik Ni določen Neznano 2026-03-31 12:50:39 2026-03-31 12:50:40 2026-04-01 03:58:42 0000-00-00 00:00:00 2025 0 0 Nasl. z nasl. zaslona; Opis vira z dne 9. 3. 2026; str. 1-11 Vol. 12, [article no.] 1665059 2025 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616.1 2297-055X 10.3389/fcvm.2025.1665059 270944259 RAZ_Sabovic_Miso_2025.pdf RAZ_Sabovic_Miso_2025.pdf 1 ACCAAF9FDB8DA94C130946962640EAE5 2394f39ddf985ab5a44b0e132c67e6a1240af5e871addc5492e47b49dce56340 a976fe27-2cef-11f1-9147-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=42756 https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2025.1665059/full 1 75d00f50-2cef-11f1-9147-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=42755 Univerzitetni klinični center Ljubljana 0 0 0