Clear Pathway: ruolo dell’acido bempedoico nelle strategie ipolipemizzanti. Il parere dei cardiologi del Piemonte e della Valle d’Aosta

BACKGROUND: Although international guidelines recommend increasingly lower thresholds for low-density lipoprotein cholesterol (LDL-C), everyday clinical experience shows that many patients fail to reach these targets, exposing themselves to a significant residual cardiovascular risk. Clear Pathway - a patient-centered approach to dyslipidemia - was developed to bridge this gap by promoting an integrated use of oral lipid-lowering therapies. METHODS: In the Clear Pathway project, a panel of hospital cardiologists applied a mini-Delphi methodology in two rounds to evaluate 20 statements related to lipid-lowering therapy, divided into three thematic areas: oral combination and fixed-dose strategies; use of LDL-C target distance as a guide to treatment decisions; and personalization based on patient's clinical profile. Each statement was rated on a 1-5 Likert scale and approved if the average score was ≥4.0. Statements not approved in the first round were reformulated and resubmitted. RESULTS: In the first round, 17 out of 20 statements met the consensus threshold and were approved without any modification. The three statements not approved (early intensification in post-acute coronary syndrome patients with LDL-C