Evidence map›Paper›PMID 37090089›Full record

ArticleThe Lancet regional health. Europe2023

Treatment gaps in the implementation of LDL cholesterol control among high- and very high-risk patients in Europe between 2020 and 2021: the multinational observational SANTORINI study.

Kausik K Ray, Inaam Haq, Aikaterini Bilitou, Marius C Manu, Annie Burden, Carlos Aguiar, Marcello Arca, Derek L Connolly, Mats Eriksson, Jean Ferrières and 9 more

2 registry-linked trialsAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet regional health. Europe, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 189 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
189citing papers in PubMed, 7 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04271280 completednot on this map

Treatment of High and Very High riSk Dyslipidemic pAtients for the PreveNTion of CardiOvasculaR Events in Europe - a MultInatioNal ObservatIonal Study (SANTORINI)

TypeobservationalSponsorDaiichi Sankyo Europe, GmbH, a Daiichi Sankyo CompanyRan2020 to 2022Enrolled9,559ConditionsDyslipidemia, Cardiovascular Diseases, Hypercholesterolemia, Atherosclerotic Cardiovascular DiseaseArmsNon-interventional
NCT07252388 nanot yet recruitingnot on this mapstarted 2025, after this paper: background citation

Educational Intervention for Patient's Awareness on eaRly LDL-C Lowering Using Novel Pharmacological Strategies in secondarY Prevention (EARLY)

TypeinterventionalSponsorHeart Care FoundationRan2025 to 2027Enrolled240ConditionsAcute Coronary Syndromes, Chronic Coronary SyndromesArmsPatient-oriented educational intervention
3 · Its place in the literature

Who cites it

189 citing papers in PubMed, 7 syntheses or guidelines pooled it.

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  14. Long-term LDL-C lowering and treatment persistence with inclisiran: 3-year follow-up from the German Inclisiran Network.Clinical research in cardiology : official journal of the German Cardiac Society · 2026
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  17. Gaps in lipid management among high-risk patients without prior MI or stroke: the VESALIUS-REAL global study.Clinical research in cardiology : official journal of the German Cardiac Society · 2026
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129 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Kausik K RayImperial Centre for Cardiovascular Disease Prevention, ICTU-Global, Imperial College London, London, UK.
Inaam HaqMedical Affairs, Daiichi Sankyo Europe, Munich, Germany.
Aikaterini BilitouHealth Economics and Outcomes Research, Daiichi Sankyo Europe, Munich, Germany.
Marius C ManuMedical Affairs, Daiichi Sankyo Europe, Munich, Germany.
Annie BurdenBiostatistics and Data Management, Daiichi Sankyo Europe, Munich, Germany.
Carlos AguiarAdvanced Heart Failure and Heart Transplantation Unit, Heart Institute, Carnaxide, Portugal.
Marcello ArcaDepartment of Translational and Precision Medicine, Sapienza Università di Roma, Rome, Italy.
Derek L ConnollySandwell and West Birmingham NHS Trust, Birmingham City Hospital, Institute of Cardiovascular Sciences, University of Birmingham, and Aston Medical School, Birmingham, UK.
Mats ErikssonDepartment of Medicine, Karolinska University Hospital, Stockholm, Sweden.
Jean FerrièresDepartment of Cardiology and INSERM UMR 1295, Toulouse Rangueil University Hospital, Toulouse University School of Medicine, Toulouse, France.
Ulrich LaufsDepartment of Cardiology, University Hospital Leipzig, Leipzig, Germany.
Jose M MostazaDepartment of Internal Medicine, La Paz-Carlos III Hospital, Madrid, Spain.
David NanchenCenter for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.
Ernst RietzschelDepartment of Internal Medicine and Pediatrics, Ghent University and Ghent University Hospital, Ghent, Belgium.
Timo StrandbergDepartment of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Hermann ToplakDivision of Endocrinology and Diabetology, Department of Medicine, Medical University of Graz, Graz, Austria.
Frank L J VisserenDepartment of Vascular Medicine, University Medical Center Utrecht, Utrecht, the Netherlands.
Alberico L CatapanoDepartment of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy.
SANTORINI Study Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: European data pre-2019 suggest statin monotherapy is the most common approach to lipid management for preventing cardiovascular (CV) events, resulting in only one-fifth of high- and very high-risk patients achieving the 2019 ESC/EAS recommended low-density lipoprotein cholesterol (LDL-C) goals. Whether the treatment landscape has evolved, or gaps persist remains of interest. Methods: Baseline data are presented from SANTORINI, an observational, prospective study that documents the use of lipid-lowering therapies (LLTs) in patients ≥18 years at high or very high CV risk between 2020 and 2021 across primary and secondary care settings in 14 European countries. Findings: Of 9602 enrolled patients, 9044 with complete data were included (mean age: 65.3 ± 10.9 years; 72.6% male). Physicians reported using 2019 ESC/EAS guidelines as a basis for CV risk classification in 52.0% (4706/9044) of patients (overall: high risk 29.2%; very high risk 70.8%). However, centrally re-assessed CV risk based on 2019 ESC/EAS guidelines suggested 6.5% (308/4706) and 91.0% (4284/4706) were high- and very high-risk patients, respectively. Overall, 21.8% of patients had no documented LLTs, 54.2% were receiving monotherapy and 24.0% combination LLT. Median (interquartile range [IQR]) LDL-C was 2.1 (1.6, 3.0) mmol/L (82 [60, 117] mg/dL), with 20.1% of patients achieving risk-based LDL-C goals as per the 2019 ESC/EAS guidelines. Interpretation: At the time of study enrolment, 80% of high- and very high-risk patients failed to achieve 2019 ESC/EAS guidelines LDL-C goals. Contributory factors may include CV risk underestimation and underutilization of combination therapies. Further efforts are needed to achieve current guideline-recommended LDL-C goals. Trial registration: ClinicalTrials.gov Identifier: NCT04271280. Funding: This study is funded by Daiichi Sankyo Europe GmbH, Munich, Germany.

Indexed as

Cardiovascular diseaseCohort studyHigh cardiovascular riskLDL cholesterolLipid-lowering therapyReal-world evidence

Identifiers

PMID37090089
PMCPMC10119631

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.