INTRODUCTION: A retrospective/prospective observational study was conducted to explore the current management of hyperlipidaemia in high-risk (HR) and very high risk (VHR) patients in central/eastern Europe and Israel. METHODS: The study enrolled adult patients who were receiving lipid-lowering therapy and attending a specialist (cardiologist/diabetologist/lipidologist) or internist for a routine visit at 57 sites (including academic/specialist/internal medicine centres) across Bulgaria, Croatia, Czech Republic, Israel, Poland, Romania and Slovakia. Data were collected from medical records, for the 12 months before enrolment, with/without ≤ 6 months' additional prospective follow-up. RESULTS: A total of 1244 patients, mean (SD) age 63.3 (11.3) years were included (307 with familial hypercholesterolaemia (FH), 943 secondary prevention patients). Almost all patients (98.1%) were receiving statins (76.7% monotherapy/21.4% combined therapy), with 53.1% receiving high-intensity statin therapy: 127 patients (10.2%) had adverse events attributed to statin intolerance. Mean (SD) low density lipoprotein cholesterol (LDL-C) levels were 3.3 (1.7) mmol/L at the first, and 2.7 (1.3) mmol/L at the last, visit of the retrospective phase of observation, with little change during the prospective phase. Less than one-quarter (23.8%; 95% CI 17.29-31.45%) of HR patients and less than half (42.0%; 39.05-44.98%) of VHR patients achieved their risk-based LDL-C targets of < 2.5 and < 1.8 mmol/L, respectively. Less than 15% of FH patients reached these targets (10.9% (5.6-18.7%) of HR and 12.1% (8.0-17.4%) of VHR patients). The revised 2016 ESC/EAS target for HR patients (2.6 mmol/L) was met by 28.5% (21.44-36.38%) of HR patients overall. Almost one-half of patients (42.1%) experienced one or more cardiovascular events during observation. CONCLUSION: Our findings confirm that, despite widespread statin use, a substantial proportion of patients treated for hyperlipidaemia in central/eastern Europe and Israel, particularly those with FH, do not reach recommended LDL-C targets, thus remaining at risk of cardiovascular events. FUNDING: Amgen (Europe) GmbH.

Amgen Bulgaria EOOD Sofia Bulgaria

Amgen Ltd Cambridge UK

Cardiology Clinic Jan Kochanowski University in Kielce Kielce Swietokrzyskie Poland

CardioPrevent Foundation University of Medicine and Pharmacy Timisoara Romania

Centre of Preventive Cardiology 3rd Department of Internal Medicine Charles University Prague General University Hospital Prague Czech Republic

Department of Cardiovascular Medicine Lady Davis Carmel Medical Centre Haifa Israel

Department of Internal Medicine Faculty of Dentistry University of Zagreb Zagreb Croatia

MetabolKLINIKsro Department for Diabetes and Metabolic Disorders Lipid Clinic MED PED Centre Bratislava Slovakia

University Clinic of Cardiology Angiology and Electrophysiology City Clinic Cardiovascular University Centre University of Sofia Sofia Bulgaria

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