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Lipid-lowering therapy and LDL cholesterol control among high- and very high-risk patients in Portugal: An analysis of the SANTORINI study

2026-02Artigo científico Acesso aberto
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datacite.subject.sdg03:Saúde de Qualidade
datacite.subject.sdg10:Reduzir as Desigualdades
datacite.subject.sdg09:Indústria, Inovação e Infraestruturas
dc.contributor.authorAguiar, Carlos
dc.contributor.authorAguiar, Patrício
dc.contributor.authorDuarte, João Sequeira
dc.contributor.authorGil, Victor
dc.contributor.authorMimoso, Jorge
dc.contributor.authorMonteiro, Pedro
dc.contributor.authorPinto, Fausto J.
dc.contributor.authorPinto, Fernando
dc.contributor.authorRaposo, João
dc.contributor.authorvon Hafe, Pedro
dc.contributor.authorRuivo, Jorge A.
dc.contributor.authorTeixeira, Carla
dc.contributor.authorCatapano, Alberico L.
dc.contributor.authorRay, Kausik K.
dc.date.accessioned2026-05-07T10:11:19Z
dc.date.available2026-05-07T10:11:19Z
dc.date.issued2026-02
dc.description.abstractIntroduction and objectives: The SANTORINI study is the first large-scale, European observational study conducted following the release of the 2019 European Society of Cardiology/European Atherosclerosis Society ESC/EAS guidelines on dyslipidemia management. This analysis aims to assess lipid-lowering therapy (LLT) use and low-density lipoprotein cholesterol (LDL-C) goal attainment in patients at high or very high cardiovascular (CV) risk enrolled in Portugal. Methods: In Portugal, 117 patients were enrolled across 10 sites between September 2020 and February 2021. Paired LDL-C values at baseline and one-year follow-up were available for 102 patients. LDL-C levels, LLT utilization patterns, and LDL-C goal attainment (as per the 2019 ESC/EAS guidelines) were assessed at both time points and compared with the broader European cohort, excluding Portuguese participants. Results: Over the one-year follow-up, the use of statin monotherapy decreased from 49.5% to 45.2%, while combination therapy with statin and ezetimibe increased from 35.9% to 40.9%. LLT intensity was escalated in 12.8% of patients, unchanged in 79.5%, and de-escalated in 6.0%. Mean LDL-C levels were similar between baseline and one-year follow-up: corresponding values were 90.2 mg/dL and 90.1 mg/dL in high-risk patients, and 74.1 mg/dL and 75.2 mg/dL in very high-risk patients. LDL-C goal attainment declined from 34.1% to 22.7% in high-risk patients and 27.6% to 22.4% in very high-risk patients. Conclusions: The Portuguese cohort of the SANTORINI study demonstrates both encouraging developments and ongoing challenges in the real-world management of dyslipidemia following the 2019 ESC/EAS guidelines. Reasons for lack of LLT intensification and factors underlying worsening rates for LDL-C goal attainment should be explored. (c) 2025 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).eng
dc.identifier.doi10.1016/j.repc.2025.10.003
dc.identifier.issn0870-2551
dc.identifier.urihttp://hdl.handle.net/10400.1/28879
dc.language.isoeng
dc.peerreviewedyes
dc.publisherElsevier
dc.relation.hasversionhttps://www.sciencedirect.com/science/article/pii/S0870255125003440?via%3Dihub
dc.relation.ispartofRevista Portuguesa de Cardiologia
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectAgentes reguladores de lípidos
dc.subjectCardiometabolic risk factors
dc.subjectCholesterol
dc.subjectColesterol
dc.subjectEstudo observacional
dc.subjectFatores de risco cardiometabólicos
dc.subjectLDL
dc.subjectLipid regulating agents
dc.subjectObservational study
dc.titleLipid-lowering therapy and LDL cholesterol control among high- and very high-risk patients in Portugal: An analysis of the SANTORINI studyeng
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage64
oaire.citation.issue2
oaire.citation.startPage51
oaire.citation.titleRevista Portuguesa de Cardiologia
oaire.citation.volume45
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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