Abstract
AIMS: Office-based cardiologists (OBCs) and general practitioners (GPs) follow different approaches for hypercholesterolemia management in atherosclerotic cardiovascular disease (ASCVD). This study evaluates whether differences in clinical practice between OBCs and GPs contribute to existing gaps in low-density lipoprotein cholesterol (LDL-C) control and lipoprotein(a) [Lp(a)] screening in ASCVD care. METHODS: LipidSnapshot is a collaborative research initiative comprising a prospective non-interventional study at OBCs and a retrospective analysis of GP records. It evaluates LDL-C target attainment, Lp(a) testing, and lipid-lowering therapies (LLT) in the OBC and the GP setting. Subgroup analyses by gender and age are conducted. RESULTS: The dataset comprises 1,500 ASCVD patients from OBCs and 82,375 patients from GPs. The median LDL-C levels were 68 mg/dL (OBC) vs. 88 mg/dL (GP). LDL-C targets < 55 mg/dL were achieved in 27.4% of patients (OBC) vs. 12.1% of patients (GP). Lp(a) testing rate was 20.3% (OBC) vs. 3.0% (GP). The proportion of patients not receiving any LLT was 1.5% (OBC) vs. 26.6% (GP). LDL-C levels were numerically higher in female patients as well as in younger patients especially in the GP setting. Female patients were less likely to receive LLT compared to their male counterparts and half of the GP patients < 50 years of age remained untreated at all. CONCLUSION: A large proportion of ASCVD patients in Germany are inadequately treated, with notable differences between GPs and OBCs. Additionally, gender and age-related disparities are evident. There is a clear need for these gaps to be addressed to improve cross-sectional patient care.