CONGRESS ABSTRACT

The appropriate management of dyslipidemic patients represents an emerging challenge in healthcare, both in primary and secondary prevention. The recent introduction of numerous therapeutic options faces real-world data indicating that high-risk patients are significantly undertreated and that healthcare organization systems are costly and inefficient. The cornerstone of managing these patients is the careful selection of ideal candidates for intensive lipid-lowering treatment by analyzing clinical data as well as cost-effectiveness evaluations and appropriateness of prescriptions. In this context, multidisciplinary collaboration can enhance the potentials of public health care organizations. Based on these premises, and considering that various medical specialties are involved in addressing the common pathophysiology of atherosclerosis, the multidisciplinary working group of ASST Mantova has developed a clinical pathway in 2024 aimed at achieving target C-LDL levels in primary and secondary cardiovascular patients. It involves a thorough selection of patients eligible for intensive lipid-lowering treatment with regard to cost-effectiveness and prescription appropriateness. Special emphasis has been placed on identifying those clinical profiles at very high risk of ischemic recurrences where achieving extremely low cholesterol levels is indicated (the strategy being the higher the risk, the greater the benefit). In the realm of primary prevention, attention has been focused on strategies aimed at both optimizing therapeutic adherence and early identification of patients with monogenic forms of familial hypercholesterolemia, to proceed with disease screening in first-degree relatives. In secondary prevention, the practical management of patients with acute cardio-cerebrovascular events is analyzed, identifying three main intervention scenarios based on the presenting cholesterol levels. In conclusion, the clinical pathway for the management of dyslipidemias proposes itself as an essential tool for integrating hospital pathways with community care to stratify and reduce cardiovascular risk in the population, promote therapeutic adherence, and provide assessments on when to direct patients for specialist evaluations.