Physicians' Academy for Cardiovascular Education

Larger gap between guidelines and clinical practice for LDL-c management in East-Central Europe

News - June 3, 2021

Are risk-based LDL-C goals achieved in primary and secondary care in Central and Eastern Europe? Comparison with other Europe regions from the DA VINCI observational study

Presented at the virtual EAS 2021 by Michal Vrablik, MD, PhD (Prague, Czech Republic)

Introduction and methods

The DA VINCI study has assessed the proportion of patients who according to the 2016 and 2019 ESC/EAS guidelines attained their LDL-c goals with lipid lowering therapy (LLT) for primary or secondary care. In total, 5888 patients from 128 different sites across 18 EU countries were between June 2017 and November 2018 included. These patients were treated in the past 12 months with any LLT and had an LDL-c measurement within the past 14 months.

Whether regional differences in Europe exist for LDL-c attainment goals in patients on LLT for primary or secondary care has not been explored. This subanalysis of the DA VINCI study assessed the proportion of patients from Central and Eastern European (CEE) regions who achieved LDL-c recommendations according to the 2016 and 2019 ESC/EAS guidelines. In addition, these LDL-c attainment results were compared to LDL-c levels achieved by those from the Northern and Western European regions.

The DA VINCI cohort was divided into three regional cohorts. A CEE cohort (n=2154) with data from the Czech Republic, Hungary, Poland, Romania, Slovakia, and Ukraine; a North-European cohort which included data from Denmark and Sweden (n=287); and a West-European cohort that included data from Austria, Belgium, France, Germany, Greece, Ireland, Italy, The Netherlands, Spain, and the UK (n=3249). Baseline characteristics of the three regional cohorts were, apart from a higher percentage of patients with hypertension in the CEE-cohort, comparable.

Main results


The subanalysis of the DA VINCI study demonstrated that the overall risk-based LDL-c goal attainment using the 2016 or 2019 ESC/EAS guidelines in patients with LLT was lower in the CEE region compared to those from North- and West-Europe. Similar results were obtained for patients in the primary and secondary prevention setting. The majority of patients in CEE received moderate intensity statin monotherapy.

Vrablik ended his presentation by saying that these findings provide evidence for the need to increase accessibility of LLT in CEE countries. These results can be used to start the discussion with authorities and stakeholders to improve accessibility and thereby improve the proportion of patients getting to their LDL-c goal.

-Our reporting is based upon the information provided at the EAS 2021 congress -

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