Management of Dyslipidemia in Valle Camonica: A Clinical Journey Between Innovation and Tradition

Management of Dyslipidemia in Valle Camonica: A Clinical Journey Between Innovation and Tradition

Achievement and Maintenance of LDL Cholesterol Targets in Patients at High and Very High Cardiovascular Risk

Lorenzo Grassi¹; Mariangela Piazzani²; Claudia Salice²; Laura Tosetti²; Luciana Taboni²; Alberto Madureri²

¹ Cardiology, ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
² Cardiology Unit, ASST Valcamonica and Radiology Unit, ASST Valcamonica, Esine, Brescia, Italy

Abstract

Background: Elevated LDL-C is a major modifiable risk factor for atherosclerotic cardiovascular disease. Despite guideline recommendations, many high-risk coronary patients fail to achieve target LDL-C levels due to suboptimal therapy adherence and limited access to follow-up care. Telemedicine has emerged as a promising strategy to improve continuity of care, therapeutic adherence, and timely treatment adjustments in geographically dispersed populations.

Objective: To evaluate the effectiveness of a structured telemedicine follow-up program combined with optimized lipid-lowering therapy in achieving and maintaining LDL-C targets in high and very high cardiovascular (CV) risk patients with coronary disease.

Methods: Patients with acute or chronic coronary syndrome under 80 years of age were enrolled. A dedicated informatics system facilitated follow-up, including teleconsultation, laboratory reminders, and therapeutic education. Lipid parameters and therapy distributions were monitored over time.

Results: Interim analysis of 134 patients shows an increase in LDL-C target attainment from 48% at baseline to 70% at follow-up, with mean LDL-C decreasing from 66.9 to 44.9 mg/dL. Most patients maintained recommended lipid profiles with combination therapy and lifestyle interventions.

Conclusions: Structured telemedicine follow-up and contemporary lipid-lowering treatments (including PCSK9 inhibitors and siRNA) markedly improve LDL-C control in high-risk patients, supporting continuity of care and resource optimization.

Keywords: LDL cholesterol; Very High Cardiovascular Risk; Prevention; Telemedicine; PCSK9 inhibitors.

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