Use of combination therapy is associated with improved LDL cholesterol management: 1-year follow-up results from the European observational SANTORINI study

Cardiovascular (CV) diseases, a group of disorders of the heart and blood vessels, are the most common cause of death worldwide. Lowering LDL cholesterol (LDL-C) in the bloodstream reduces the risk of the development of CV diseases such as heart attacks and strokes. Guidelines recommend that those at the highest risk of CV disease should achieve the lowest levels of LDL-C. Several medications are available that help lower LDL-C levels and prevent CV events; however, recent studies have shown that the majority of patients continue to have LDL-C levels above optimal value in part due to a suboptimal use of these medications. In this study, we report the results after 1 year of follow-up of the SANTORINI study (started in 2020), which aimed to document the management of LDL-C in clinical practice across 14 countries in Europe. We found that a better control of LDL-C occurred when more than one drug was used (combination therapy). The use of combination therapy was low at the start of the study (25.6%) but increased over 1 year to 37.9%, resulting in a better control of LDL-C at 1 year than observed at the start of the study. Nonetheless, only 31% of patients achieved their LDL-C target levels based on the European guidelines. A greater use of combination therapies is needed in order to improve the overall population-level control of LDL-C.