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

Jean Ferrières; Kausik K Ray; Alberico L Catapano; Radhouan Allouche; Christian Becker; Aurélie Bardet; Michel Farnier

doi:10.3389/fcvm.2026.1748457

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

Front Cardiovasc Med. 2026 Mar 12:13:1748457. doi: 10.3389/fcvm.2026.1748457. eCollection 2026.

Authors

Jean Ferrières¹, Kausik K Ray², Alberico L Catapano^{3

4}, Radhouan Allouche⁵, Christian Becker⁶, Aurélie Bardet⁶, Michel Farnier⁷

Affiliations

¹ Department of Cardiology and INSERM UMR 1295, Toulouse Rangueil University Hospital, Toulouse University School of Medicine, Toulouse, France.
² Imperial Centre for Cardiovascular Disease Prevention, ICTU-Global, Imperial College London, London, United Kingdom.
³ Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy.
⁴ Department of Pharmacological and Biomedical Sciences, University of Milan Multimedica IRCCS, Milan, Italy.
⁵ Daiichi Sankyo Europe GmbH, Rueil-Malmaison, France.
⁶ Daiichi Sankyo Europe GmbH, Munich, Germany.
⁷ PEC2 team, UR7460, University of Burgundy Europe, Dijon, France.

Abstract

Background: 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.

Materials and methods: 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.

Results: 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.

Conclusions: 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.

Keywords: cardiovascular risk; cohort study; combination therapy; lipid-lowering therapy; low-density lipoprotein cholesterol; observational.