# Lipid management in high cardiovascular risk patients in France: a comparison with rest of Europe patients from 1-year follow-up of SANTORINI

**Authors:** Jean Ferrières, Kausik K. Ray, Alberico L. Catapano, Radhouan Allouche, Christian Becker, Aurélie Bardet, Michel Farnier

PMC · DOI: 10.3389/fcvm.2026.1748457 · Frontiers in Cardiovascular Medicine · 2026-03-12

## TL;DR

This study compares lipid management and treatment outcomes in high-risk cardiovascular patients in France versus other European countries over one year.

## Contribution

The study provides new insights into lipid-lowering therapy patterns and LDL-C goal attainment in France compared to the rest of Europe.

## Key findings

- Use of combination lipid-lowering therapies increased from 25.3% to 38.2% in France over one year.
- LDL-C goal attainment improved from 14.8% to 23.4% in the France cohort during the study period.
- Despite improvements, most patients in France remained at high or very high cardiovascular risk.

## Abstract

The SANTORINI study (NCT04271280) was designed to assess lipid management in different European countries and care settings over 1 year of follow-up. Here, we report prospective findings of patient characteristics, low-density lipoprotein cholesterol (LDL-C) goal attainment, and treatment patterns of lipid-lowering therapies (LLTs) in France and the rest of Europe (RoE; without France) at 1-year follow-up.

Patients at high or very high cardiovascular (CV) risk were recruited across 14 European countries from 17 March 2020 to 11 February 2021 and followed for 1 year of prospective follow-up.

Among 9,559 patients enrolled in the study, 8,802 with available risk classification data and 7,210 with available LDL-C data at baseline and 1-year follow-up were included. Of patients with available LDL-C data, 621 were included in the France cohort and 6,589 were included in the RoE cohort. In the France cohort (full analysis set for risk), investigators classified 20.1% and 79.9% of patients as high and very high CV risk, respectively. When CV risk was recalculated centrally as per the 2019 European Society of Cardiology/European Atherosclerosis Society guidelines, 7.1% and 92.9% of patients in the France cohort were considered high and very high risk, respectively. Total LLT monotherapy and combination therapy use over 1 year increased from 51.2% to 58.5% and 25.3% to 38.2%, respectively. Overall, mean (standard deviation) LDL-C level decreased from 2.6 (1.3) mmol/L to 2.2 (1.2) mmol/L, and LDL-C goal attainment increased from 14.8% to 23.4%. Results in the France cohort were consistent with those observed in the RoE cohort.

While use of combination LLT and LDL-C goal attainment increased in the France cohort over 1 year of follow-up, the majority of patients remained at an increased risk of CV events.

## Linked entities

- **Diseases:** cardiovascular disease (MONDO:0004995)

## Full-text entities

- **Diseases:** Atherosclerosis (MESH:D050197)
- **Chemicals:** Lipid (MESH:D008055), LLT (-)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

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## References

16 references — full list in the complete paper: https://tomesphere.com/paper/PMC13017259/full.md

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Source: https://tomesphere.com/paper/PMC13017259