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Patients presented at least (i) 1 year of clinical data before inclusion, (ii) one primary care appointment 3 years before the index date, and (iii) sufficient data for CV risk classification. Patients were divided into three cohorts: high CV risk; atherosclerotic cardiovascular disease (ASCVD) risk equivalents without established ASCVD; evidence of ASCVD. CV risk and LDL\u2010C control were defined by the 2019 and 2016 European Society of Cardiology (ESC)\/European Atherosclerosis Society (EAS) dyslipidemia guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 51\u2009609 patients were included, with 23\u2009457 patients classified as high CV risk, 19\u2009864 with ASCVD equivalents, and 8288 with evidence of ASCVD. LDL\u2010C control with 2016 ESC\/EAS guidelines was 32%, 10%, and 18% for each group, respectively. Considering the ESC\/EAS 2019 guidelines control level was even lower: 7%, 3%, and 7% for the same cohorts, respectively. Patients without any LLT prescribed ranged from 37% in the high CV risk group to 15% in patients with evidence of ASCVD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We found that LDL\u2010C control was very low in patients at higher risk of CV events. An alarming gap between guidelines on dyslipidemia management and clinical implementation persists, even in those at very high risk or with established ASCVD.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.24183","type":"journal-article","created":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T07:04:50Z","timestamp":1699340690000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Characterization and LDL\u2010C management in a cohort of high and very high cardiovascular risk patients: The PORTRAIT\u2010DYS study"],"prefix":"10.1002","volume":"47","author":[{"given":"Cristina","family":"Gavina","sequence":"first","affiliation":[{"name":"Hospital Pedro Hispano \u2010 Unidade Local de Sa\u00fade de Matosinhos  Portugal"},{"name":"Department of Medicine, Faculty of Medicine Porto University Porto Portugal"},{"name":"UnIC, Faculty of Medicine Porto University Porto Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5299-9341","authenticated-orcid":false,"given":"Daniel","family":"Seabra\u2010Carvalho","sequence":"additional","affiliation":[{"name":"Hospital Pedro Hispano \u2010 Unidade Local de Sa\u00fade de Matosinhos  Portugal"}]},{"given":"Carlos","family":"Aguiar","sequence":"additional","affiliation":[{"name":"Advanced Heart Failure Unit, Department of Cardiology Hospital Santa Cruz, CHLO Lisbon Portugal"}]},{"given":"Anastassia","family":"Anastassopoulou","sequence":"additional","affiliation":[{"name":"Value and Access Daiichi Sankyo Europe GmbH  Germany"}]},{"given":"Carla","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Medical Affairs Daiichi Sankyo Portugal Porto Salvo Portugal"}]},{"given":"Jorge A.","family":"Ruivo","sequence":"additional","affiliation":[{"name":"Medical Affairs Daiichi Sankyo Portugal Porto Salvo Portugal"},{"name":"Department of Medicine, Lisbon Medical School Lisbon University  Portugal"},{"name":"Centro Cardiovascular Universidade Lisboa Lisbon University  Portugal"}]},{"given":"\u00c9lia","family":"Almeida","sequence":"additional","affiliation":[{"name":"Value and Access Daiichi Sankyo Portugal Porto Salvo Portugal"}]},{"given":"Leonor","family":"Luz\u2010Duarte","sequence":"additional","affiliation":[{"name":"UCSP Cinf\u00e3es ACeS Baixo  Portugal"},{"name":"MTG Research and Development Lab Porto Portugal"}]},{"given":"Ana","family":"Corte\u2010Real","sequence":"additional","affiliation":[{"name":"MTG Research and Development Lab Porto Portugal"},{"name":"UCSP Barroselas Unidade Local de Sa\u00fade do Alto Minho  Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6487-313X","authenticated-orcid":false,"given":"Mariana","family":"Canelas\u2010Pais","sequence":"additional","affiliation":[{"name":"MTG Research and Development Lab Porto Portugal"},{"name":"Department of Community Medicine, Health Information and Decision, Faculty of Medicine University of Porto Porto Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0998-6000","authenticated-orcid":false,"given":"Tiago","family":"Taveira\u2010Gomes","sequence":"additional","affiliation":[{"name":"MTG Research and Development Lab Porto Portugal"},{"name":"Department of Community Medicine, Health Information and Decision, Faculty of Medicine University of Porto Porto Portugal"},{"name":"Faculty of Health Sciences Fernando Pessoa University  Portugal"}]}],"member":"311","published-online":{"date-parts":[[2023,11,6]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx144"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab484"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz455"},{"key":"e_1_2_10_5_1","unstructured":"World Health Organization. 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