| Title: | Suboptimal management of hypercholesterolemia in countries with high or very high cardiovascular risk : findings from the international DISCOVERY study |
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| Authors: | ID Šabovič, Mišo (Author)
ID Pejkov, Hristo (Author)
ID Caraus, Alexandru (Author)
ID Gruev, Ivan (Author)
ID Vintilă, Vlad Damian (Author)
ID Csanádi, Zoltán (Author)
ID Batjargal, Sodgerel (Author)
ID Kovačević -Preradović, Tamara (Author)
ID Kusljugić, Zumreta (Author)
ID Kuprešak, Draško (Author), et al. |
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| Files: |  PDF - Presentation file, download (921,50 KB)
MD5: ACCAAF9FDB8DA94C130946962640EAE5
 URL - Source URL, visit https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2025.1665059/full
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| Language: | English |
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| Typology: | 1.01 - Original Scientific Article |
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| Organization: |  UKC LJ - Ljubljana University Medical Centre
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| Abstract: | 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. |
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| Keywords: | LDL-C, hypercholesterolemia, lipid-lowering therapy, ESC/EAS guidelines, cardiovascular risk, real-world evidence, statins, ezetimibe |
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| Publication status: | Published |
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| Publication version: | Version of Record |
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| Year of publishing: | 2025 |
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| Number of pages: | str. 1-11 |
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| Numbering: | Vol. 12, [article no.] 1665059 |
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| PID: | 20.500.12556/DiRROS-28735  |
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| UDC: | 616.1 |
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| ISSN on article: | 2297-055X |
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| DOI: | 10.3389/fcvm.2025.1665059 |
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| COBISS.SI-ID: | 270944259 |
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| Note: | Nasl. z nasl. zaslona;
Opis vira z dne 9. 3. 2026;
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| Publication date in DiRROS: | 31.03.2026 |
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| Views: | 39 |
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| Downloads: | 17 |
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