{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T12:22:57Z","timestamp":1790252577117,"version":"4.1.0"},"reference-count":46,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,1,14]],"date-time":"2025-01-14T00:00:00Z","timestamp":1736812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: This study assessed the proportion of secondary cardiovascular prevention patients who achieved low-density lipoprotein (LDL) cholesterol targets as per the 2019 ESC\/EAS Dyslipidemia Guidelines. We also evaluated whether lipid-lowering therapies (LLTs) were adjusted in patients not meeting targets and analyzed the likelihood of these modifications achieving recommended levels. Methods: A multicenter, cross-sectional observational study retrospectively reviewed medical records of 1909 outpatients in 9 Italian cardiac rehabilitation\/secondary prevention clinics from January 2023 to June 2024. Inclusion criteria included prior atherosclerotic cardiovascular disease (ASCVD) and recent LDL-cholesterol levels. Data included demographics, ASCVD presentation, lipid profiles, and LLTs. Patients at very high risk had LDL targets of \u226455 mg\/dL, or \u226440 mg\/dL for recurrent events within 2 years. Clinicians\u2019 approaches to LLT modification in patients not at target were recorded, with LLT efficacy estimated based on percentage distance from LDL-cholesterol targets. Results: Of the 1909 patients, 41.3% met the LDL-cholesterol target. Predictors of achieving targets included male gender, cardiac rehabilitation, recent acute coronary syndrome, diabetes, and triple therapy (statin + ezetimibe + PCSK9 inhibitors). Conversely, a target of \u226440 mg\/dL, lack of therapy, and monotherapy were negative predictors. Among 1074 patients not at target, LLT modifications were proposed for 48.6%. Predictors of LLT modification included recent ASCVD events, cardiac rehabilitation, and greater percentage distance from the LDL target, while advanced age and an LDL target of \u226440 mg\/dL were negative predictors. However, only 42.3% of modified therapies were predicted to be effective in reaching LDL targets. Conclusions: Despite 2019 ESC\/EAS guidelines, a significant proportion of high-risk patients did not achieve LDL targets, and proposed LLT modifications were often insufficient. More intensive LLT regimens are needed to improve outcomes in this population.<\/jats:p>","DOI":"10.3390\/jcm14020493","type":"journal-article","created":{"date-parts":[[2025,1,14]],"date-time":"2025-01-14T06:13:07Z","timestamp":1736835187000},"page":"493","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Therapeutic Inertia in Dyslipidemia Management for Secondary Cardiovascular Prevention: Results from the Italian ITACARE-P Network"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3247-3203","authenticated-orcid":false,"given":"Andrea","family":"Faggiano","sequence":"first","affiliation":[{"name":"Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"},{"name":"Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Gualeni","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Fondazione Poliambulanza, 25124 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Barbieri","sequence":"additional","affiliation":[{"name":"Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"},{"name":"Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gian Francesco","family":"Mureddu","sequence":"additional","affiliation":[{"name":"Cardiology and Cardiac Rehabilitation Unit, San Giovanni Hospital Complex, 00184 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7223-7574","authenticated-orcid":false,"given":"Elio","family":"Venturini","sequence":"additional","affiliation":[{"name":"Unit of Cardiac Rehabilitation, Civil Hospital Cecina (LI), 57023 Cecina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4119-9397","authenticated-orcid":false,"given":"Francesco","family":"Giallauria","sequence":"additional","affiliation":[{"name":"Precision Internal Medicine Unit, Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9878-4565","authenticated-orcid":false,"given":"Marco","family":"Ambrosetti","sequence":"additional","affiliation":[{"name":"Cardiovascular Rehabilitation Unit, ASST Crema, Rivolta D\u2019Adda Hospital, 26027 Rivolta d\u2019Adda, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0319-2621","authenticated-orcid":false,"given":"Matteo","family":"Ruzzolini","sequence":"additional","affiliation":[{"name":"Cardiology Department, Isola Tiberina-Gemelli Isola Hospital, 00186 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7933-7663","authenticated-orcid":false,"given":"Francesco","family":"Maranta","sequence":"additional","affiliation":[{"name":"Cardiovascular Rehabilitation Unit, San Raffaele Scientific Institute, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Vittoria","family":"Silverii","sequence":"additional","affiliation":[{"name":"SOD Cardiologic Rehabilitation Unit, Careggi University Hospital, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Garau","sequence":"additional","affiliation":[{"name":"Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"},{"name":"Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Garamella","sequence":"additional","affiliation":[{"name":"Unit of Cardiac Rehabilitation, Civil Hospital Cecina (LI), 57023 Cecina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3366-2321","authenticated-orcid":false,"given":"Raffaele","family":"Napoli","sequence":"additional","affiliation":[{"name":"Precision Internal Medicine Unit, Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Maresca","sequence":"additional","affiliation":[{"name":"Cardiovascular Rehabilitation Unit, ASST Crema, Rivolta D\u2019Adda Hospital, 26027 Rivolta d\u2019Adda, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaetano Luca","family":"Panetta","sequence":"additional","affiliation":[{"name":"Cardiology Department, Isola Tiberina-Gemelli Isola Hospital, 00186 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Maggi","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Fondazione Poliambulanza, 25124 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5166-0899","authenticated-orcid":false,"given":"Stefano","family":"Carugo","sequence":"additional","affiliation":[{"name":"Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"},{"name":"Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1345-0284","authenticated-orcid":false,"given":"Francesco","family":"Fattirolli","sequence":"additional","affiliation":[{"name":"SOD Cardiologic Rehabilitation Unit, Careggi University Hospital, 50134 Florence, Italy"},{"name":"Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7997-6908","authenticated-orcid":false,"given":"Pompilio","family":"Faggiano","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Fondazione Poliambulanza, 25124 Brescia, 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