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European Physician Survey Characterizing the Clinical Pathway and Treatment Patterns of Patients Post-Myocardial Infarction

Qureshi, Nadeem; Antoniou, Sotiris; Cornel, Jan H.; Schiele, Francois; Perrone-Filardi, Pasquale; Brachmann, Johannes; Sidelnikov, Eduard; Villa, Guillermo; Ferguson, Samara; Rowlands, Christina; González-Juanatey, José R.


Sotiris Antoniou

Jan H. Cornel

Francois Schiele

Pasquale Perrone-Filardi

Johannes Brachmann

Eduard Sidelnikov

Guillermo Villa

Samara Ferguson

Christina Rowlands

José R. González-Juanatey


Introduction: The 2019 European Society of Cardiology and European Atherosclerosis Society (2019 ESC/EAS) guidelines stress the importance of managing low-density lipoprotein cholesterol (LDL-C) after myocardial infarction (MI) to reduce the risk of cardiovascular events. Information on guideline implementation is limited. The aim of this survey was to describe current clinical practice regarding LDL-C management in the first year post-MI across Europe, improving understanding of the role of ESC/EAS guidelines on clinical practice. Methods: A qualitative web-based cross-sectional physician survey about the patient pathway and LDL-C management post-MI was conducted in 360 physicians from France, Italy, Germany, The Netherlands, Spain, and the UK (n = 60/country) between December 2019 and June 2020. Secondary and primary care physicians (SCPs/PCPs) described their experiences treating patients post-MI over the preceding 2months. Results: Physicians reported that on average 90.7% of patients not prescribed lipid-lowering therapy (LLT) before an MI initiated LLT as inpatients; for patients already taking LLT, treatment was intensified for 64.7% of inpatients post-MI. SCPs reported prescribing higher-intensity statins and/or ezetimibe for between 72.3% (Italy) and 88.6% (UK) of patients post-MI. More than 80.0% of SCPs and 51.2% of PCPs stated that they would initiate a change in LLT immediately if patients did not achieve their LDL-C treatment goal by 12weeks post-MI; 82.0% of SCPs and 55.1% of PCPs reported referring to 2019 ESC/EAS guidelines for management of patients post-MI. Barriers to initiating PCSK9 inhibitors (PCSK9is) included prior prescription of a maximally tolerated dose of statin (49.4%) and/or ezetimibe (38.9%), requirement to reach threshold LDL-C levels (44.9%), and pre-authorization requirements (30.4%). Conclusion: Differences in clinical practice post-MI were reported across the countries surveyed, including divergence between 2019 ESC/EAS and local guidelines. Increased use of innovative medicines to achieve LDL-C goals should reduce risk of subsequent cardiovascular events in very high-risk patients post-MI.


Qureshi, N., Antoniou, S., Cornel, J. H., Schiele, F., Perrone-Filardi, P., Brachmann, J., …González-Juanatey, J. R. (2022). European Physician Survey Characterizing the Clinical Pathway and Treatment Patterns of Patients Post-Myocardial Infarction. Advances in Therapy,

Journal Article Type Article
Acceptance Date Sep 29, 2022
Online Publication Date Oct 26, 2022
Publication Date Oct 26, 2022
Deposit Date Nov 2, 2022
Publicly Available Date Nov 2, 2022
Journal Advances in Therapy
Print ISSN 0741-238X
Electronic ISSN 1865-8652
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Keywords Pharmacology (medical); General Medicine
Public URL
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