Progress in Achieving LDL Cholesterol Target Levels in a High-Risk Patient Population in Slovakia.

Cochran–Armitage testing verified a highly significant positive trend in target attainment (Z = 8.42, p < 0.001).

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Introduction - Despite significant regulatory changes in Slovakia—including the lifting of prescription restrictions for statins/ezetimibe and the introduction of inclisiran and bempedoic acid—the vast majority of very high cardiovascular risk patients still fail to reach LDL-C targets, with over 93% missing guideline-recommended levels even in 2023 - Among post-ACS patients, only 2.2–5.0% achieved the target LDL-C of <1.4 mmol/L across 2020–2023; similarly low rates were seen in post-stroke patients (4.0–6.6%) and the broader very high CV risk group (1.7–3.0%) - A positive trend emerged in 2022–2023, with target attainment roughly doubling compared to the start of the observation period, likely driven by policy changes and the rollout of novel lipid-lowering therapies - Lipid monitoring frequency remains a serious concern—only 19% of ACS patients and 11% of stroke patients

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