Novel Therapies, Residual Risk, Familial Hypercholesterolemia, and Digital Tools: Multispecialty Insights from a Dyslipidemia Management Survey

Introduction/Objectives: Although contemporary cardiovascular guidelines endorse intensive low-density lipoprotein cholesterol (LDL-C) lowering and advanced lipid biomarkers for refined risk stratification, important gaps in knowledge and implementation persist. This study evaluated clinician familiarity with novel lipid-lowering therapies, approaches to residual cardiovascular risk, confidence in identifying familial hypercholesterolemia (FH), and perceived usefulness of digital decision-support tools. Methods: A multispecialty, cross-sectional online survey (October 2025) of physicians involved in dyslipidemia care was conducted. The questionnaire assessed familiarity, accessibility, and barriers regarding proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, inclisiran, and bempedoic acid; confidence and practice in managing complex populations and residual risk; confidence in detecting FH and expectations for lipoprotein(a) [Lp(a)]; and perceived value of digital decision-support and automated risk alerts. Descriptive statistics and chi-square tests were performed. Results: Ninety-five clinicians completed the survey, with the largest group (41.1%) being general practitioners. Of them, 20.0% reported familiarity with all three novel therapies, and 49.5% reported restricted access due to cost and reimbursement constraints. Overall confidence in managing dyslipidemia in complex populations was moderate. Of note, 31.6% did not routinely assess residual risk after achieving LDL-C targets. Among those who did, imaging-based evaluation of subclinical atherosclerosis was the most frequently selected approach, followed by Lp(a) and triglycerides, hs-CRP, and apoB. Confidence in recognizing FH was modest, and expectations regarding future Lp(a) testing differed across specialties. Most respondents endorsed integrated decision-support tools and automated risk-alert prompts. Conclusions: Implementation gaps persist in dyslipidemia care, while strong receptiveness to digital decision-support highlights an opportunity to align practice more closely with evidence-based recommendations.