Felice Gragnano: LDL-C Treatment Is Not Enough – Reaching the Target Matters
Felice Gragnano, Associate Professor and Cardiologist at Università Vanvitelli, shared a post on LinkedIn about a recent article he and his colleagues co-authored, published in European Journal of Internal Medicine, adding:
“Being treated is not the same as being protected.
In LDL-C management, treatment initiation is not the finish line. It is the starting line.
The real questions are:
- Has LDL-C been rechecked?
- Has the target been reached?
- Has therapy been intensified when LDL-C remains above target?
A prescription is not a target achieved.
In the Quality Matters initiative evaluating LDL-C management after acute myocardial infarction:
- approximately 1 in 5 patients had no LDL-C reassessment within 6 months
- only approximately 1 in 2 achieved the guideline-recommended LDL-C target
- approximately 2 in 5 had therapeutic inertia (LDL-C above target without treatment optimization).
If we do not recheck and intensify when needed, the LDL-C pathway stops before protection is achieved.
This is not only a lipid gap.
It is an implementation gap – between prescribing and protecting.
If LDL-C is causal, target attainment is not optional.
The LDL-C implementation loop is simple – but it must be closed:
- Measure
- Treat
- Recheck
- Intensify
- Maintain
How can we make LDL-C target attainment a routine quality-of-care metric?”
Title: Diagnostic and therapeutic inertia for LDL cholesterol management of consecutively verified patients with acute myocardial infarction
Authors: Felice Gragnano, Chiara Artana, Greta Carrara, Alice Sacco, Claudio Montalto, Marco Mennuni, Marco Zuin, Fabrizio D’Ascenzo, Fabrizio Del Nevo, Vincenzo De Sio, Leonardo De Luca, Giulia Spoto, Giuseppe Musumeci, Fabrizio Oliva, Gaetano Maria De Ferrari, Daniele Grosseto, Paolo Calabrò, Giuseppe Patti, Gianluca Campo, Sergio Leonardi 
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