Objective: Statins are one of the most prescribed medications in our country. About 2 billions CZK are being paid for them annually in the Czech Republic (CR). Objective information about to whom, why, how, by whom and with what results these medications are given is, however, missing. It was the aim of the STEP project (Statin Therapy REsults in the Real World Practice in the Czech Republic), which was carried out in the CR in 2010, to obtain the missing information.

Patients and methods: In this non-intervention retrospective survey, data from 3190 patients treated by statins for at least 12 months in specialized outpatient clinics were collected and analyzed. The primary aim was to establish the percentage of patients who attain the LDL cholesterol (LDL-C) goal during the treatment with statin lasting for at least 12 months. The patients were divided into 3 groups according to their absolute cardiovascular (CV) risk and the LDL-C goal was defined for each of these groups based on the current recommendations–group 1: primary prevention (n= 597)–LDL-C< 3.0 mmol/l; group 2: secondary prevention (n= 1901)–LDL-C< 2.5 mmol/l; group 3: very high CV risk (n= 692)–LDL-C< 2.0 mmol/l.

Results: The mean patients’ age was 63 years, 59% of the patients were males. Mean BMI= 29.3±4.6 kg/m2, systolic BP= 134±15 mmHg and diastolic BP= 80±9 mmHg. The mean duration of the treatment with statins was 3.7±2.9 years with a median of 3 years. The mean baseline LDL cholesterol concentration of 3.58±1.24 mmol/l decreased during the treatment with statins lasting for at least 12 months by 0.98 mmol/l (–22%). The LDL cholesterol goal corresponding to the given CV risk was attained in 46% of all patients (by 64% in group 1; by 50% in group 2; by 20% in group 3). LDL cholesterol concentration< 3.0 mmol/l was attained in 75% of all patients irrespective of their CV risk. Atorvastatin (54%) was the most often prescribed statin, followed by simvastatin (21%) and rosuvastatin (19%). Paradoxically, the most often prescribed dose was the same in these three most prescribed statins, ie 20 mg. Conclusion: In STEP survey, the missing information concerning the use of statins for dyslipidemia treatment in daily clinical practice in the CR was obtained. The results show that LDL cholesterol goals are attained in less than half of the patients treated with statins.