Mostaza J M, García-Ortiz L, Suárez Tembra M A, Talavera Calle P, Chimeno García J, Escolar Pérez V, Díaz-Díaz J L, Manzano-Espinosa L, Catapano A L, Ray K K, Díaz Moya G, Pedro-Botet Montoya J
Atherosclerosis Unit, Department of Internal Medicine, Hospital la Paz-Carlos III, Madrid, Spain.
Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Instituto de investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain.
Rev Clin Esp (Barc). 2025 Feb;225(2):78-84. doi: 10.1016/j.rceng.2024.11.004. Epub 2024 Nov 28.
There are very few studies evaluating lipid-lowering treatments (LLTs) and low-density lipoprotein-cholesterol (LDL-C) goal attainment after the release of the 2019 guidelines of the European Societies of Cardiology (ESC) and Atherosclerosis (EAS). This manuscript shows baseline data of the Spanish subset from SANTORINI study (namely SANTORINI Spain) on LDL-C goal attainment and use of LLTs in patients at high and very high cardiovascular risk.
SANTORINI was a multinational, prospective, observational study involving patients at high and very high cardiovascular risk from 14 European countries in primary care and specialized healthcare settings. Sociodemographic data, blood lipid levels, and lipid treatments from the 1018 Spanish participants were separately analyzed and were put into perspective with the European cohort without Spanish participants.
According to physicians, 295 (29.0%) subjects were classified as high, and 723 (71.0%) as very high cardiovascular risk. Overall, 26.5% attained risk-based LDL-C targets recommended by 2019 European guidelines, with 23.1% of patients at high cardiovascular risk and 27.9% at very high cardiovascular risk. High-intensity statin therapy in monotherapy was used in 21.8%, LLT combination therapy in 41.2%, and 10.7% were not receiving any LLT.
Baseline data from SANTORINI Spain population show that only about one-fourth of patients attain LDL-C targets recommended by the 2019 ESC/EAS guidelines in patients at high and very high risk. Despite their cardiovascular risk, patients appear to be not adequately treated, and high-intensity and combination LLT seem to be underused for cardiovascular disease prevention in the real-world setting.
gov Identifier: NCT04271280.
在欧洲心脏病学会（ESC）和动脉粥样硬化学会（EAS）2019年指南发布后，评估降脂治疗（LLT）和低密度脂蛋白胆固醇（LDL-C）目标达成情况的研究非常少。本手稿展示了圣托里尼研究（即圣托里尼西班牙研究）中西班牙亚组关于LDL-C目标达成情况以及高危和极高危心血管疾病患者使用LLT的基线数据。
圣托里尼研究是一项多中心、前瞻性、观察性研究，纳入了来自欧洲14个国家基层医疗和专科医疗环境中的高危和极高危心血管疾病患者。对1018名西班牙参与者的社会人口统计学数据、血脂水平和降脂治疗情况进行了单独分析，并与不包括西班牙参与者的欧洲队列进行了对比。
根据医生的评估，295名（29.0%）受试者被归类为高危，723名（71.0%）为极高危心血管疾病风险。总体而言，26.5%的患者达到了2019年欧洲指南推荐的基于风险的LDL-C目标；心血管疾病高危患者中这一比例为23.1%，极高危患者中为27.9%。21.8%的患者使用了高强度他汀类单药治疗，41.2%的患者使用了LLT联合治疗，10.7%的患者未接受任何LLT。
圣托里尼西班牙人群的基线数据显示，在高危和极高危患者中，只有约四分之一的患者达到了2019年ESC/EAS指南推荐的LDL-C目标。尽管这些患者存在心血管疾病风险，但似乎未得到充分治疗，在现实临床环境中，高强度和联合LLT在预防心血管疾病方面的使用似乎不足。
美国国立医学图书馆临床试验注册中心标识符：NCT04271280
