Target LDL cholesterol levels in high-risk populations in Slovakia: a retrospective study

Overview

Background: Elevated LDL cholesterol (LDL-C) levels directly affect cardiovascular risk. European recommendations for the preferred method of lowering LDL-C indicate a combination of lifestyle changes and pharmacological treatment, which is the dominant component. Despite the relatively widespread prescription of lipid-lowering drugs, many European patients, including Slovak patients, do not achieve the recommended LDL-C target values. This retrospective analysis examined the actual patterns of lipid-lowering treatment and the level of achievement of LDL-C target values in a large cohort of patients in Slovakia. Methods: This study was conducted as a retrospective analysis of anonymized LDL-C values from 2020–2023 provided by a collaborating laboratory. Overall, The study included patients diagnosed with acute coronary syndrome, stroke, and generally patients with very high cardiovascular risk. Achievement of LDL-C targets was evaluated using the thresholds established in the 2019 European guidelines. Results: A total of 366,077 LDL-C test records from 116,978 patients were analyzed. Among patients with ACS, only 2.2–5.0 % achieved the LDL-C target value < 1.4 mmol/l in individual years. The proportion of patients with extremely high LDL-C ≥ 4.9 mmol/l ranged between 6–7 %. In patients with stroke, 4.0–6.6 % reached the LDL-C target values, while 3.6–6.7 % had LDL-C levels ≥ 4.9 mmol/l. In the group of patients with very high cardiovascular risk overall, only 1.7–3.0 % achieved LDL-C

Keywords:

dyslipidemia – cardiovascular risk – target values – retrospective analysis – LDL cholesterol