Discrepancies Between Physician-Perceived and Calculated Cardiovascular Risk in Primary Prevention: Implications for LDL-C Target Achievement and Appropriate Lipid-Lowering Therapy

• DOI: 10.1007/s40292-025-00705-0
• Publication Date: 2025-02-19T05:15:11Z
• Authors: Arturo Cesaro; Vincenzo Acerbo; Francesco Scialla; Enrica Golia; Claudia Concilio; Gianmaria Scherillo; Gianantonio De Mi...; Vincenzo de Sio; Antonio Capolongo; Luisa Di Donato; Maria Grazia Monaco; Simona Sperlongano; Alberto Ruggiero; Felice Gragnano; Elisabetta Moscar...; Carmine Riccio; Paolo Calabrò
• Keywords: Primary Prevention; Primary (astronomy)

Accurate risk assessment is critical in cardiovascular (CV) prevention, yet physicians often underestimate CV risk, leading to inadequate preventive measures. This study evaluates the concordance between physician-perceived and calculated a primary prevention setting. cross-sectional included patients from Cardiology Outpatient Clinic of Caserta Hospital, Italy. Two independent cardiologists evaluated third resolved discrepancies. was using SCORE2 for with 70 years or less SCORE2-OP those more than years. The perceived risks assessed Cohen's kappa coefficient. Multivariate logistic regression analysis performed examine influence estimation on achieving low-density lipoprotein cholesterol (LDL-C) targets recommended by ESC. 389 had complete data calculation. Physician-perceived categorized 8.7% as low/moderate, 37.8% high, 53.5% very-high risk. In contrast, according SCORE2/SCORE2-OP classified 8% 5.7% 86.4% poor (Cohen's 0.208, p < 0.001). Underestimated reached LDL-C 16% cases, well-estimated 34.5%, overestimated 76.9%. Statin use significantly lower underestimated (29.2%) compared (50%) (76.9%) groups (p showed that were likely achieve (OR 5.33, CI 1.33–21.42, = 0.018), whereas 47% 0.53, 0.3–0.93, 0.027). A significant discrepancy exists underestimation over one-third patients. associated target achievement reduced statin use.