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RESEARCH PRODUCT
Practical guidance for combination lipid-modifying therapy in high- and very-high-risk patients: A statement from a European Atherosclerosis Society Task Force
Alberto Mello E SilvaMaciej BanachMaurizio AvernaEric BruckertMichel FarnierAlberico L. CatapanoWinfried MärzPaolo MagniAlberto ZambonDan GaitaJosé Luis ZamoranoLuis MasanaZeljko ReinerHeinz DrexelLale TokgozogluMichal VrablíkJane K StockEmilio Rossubject
0301 basic medicinemedicine.medical_specialtyStatinSettore MED/09 - Medicina InternaCombination therapymedicine.drug_classHigh-risk2019 ESC/EAS Dyslipidaemia GuidelineLipid goal030204 cardiovascular system & hematologyTriglyceride03 medical and health sciences0302 clinical medicineCombined treatmentcardiovascular diseaseInternal medicinemedicineHumanstriglycerides2019 ESC/EAS Dyslipidaemia Guidelines; combination treatment; LDL cholesterol; triglycerides; lipid goals; high-risk; cardiovascular diseaselipid goalsbusiness.industryTask forceAnticholesteremic AgentsPCSK9Cholesterol LDL[SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolismAtherosclerosis2019 ESC/EAS Dyslipidaemia Guidelines3. Good health030104 developmental biologyDiabetes Mellitus Type 2Combination treatmentAtherosclerosiLDL cholesterolEuropean atherosclerosis societyKexinlipids (amino acids peptides and proteins)Proprotein Convertase 9Hydroxymethylglutaryl-CoA Reductase InhibitorsCardiology and Cardiovascular MedicinebusinessVery high riskdescription
International audience; Background and aimsThis European Atherosclerosis Society (EAS) Task Force provides practical guidance for combination therapy for elevated low-density lipoprotein cholesterol (LDL-C) and/or triglycerides (TG) in high-risk and very-high-risk patients.MethodsEvidence-based review.ResultsStatin-ezetimibe combination treatment is the first choice for managing elevated LDL-C and should be given upfront in very-high-risk patients with high LDL-C unlikely to reach goal with a statin, and in primary prevention familial hypercholesterolaemia patients. A proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor may be added if LDL-C levels remain high. In high and very-high-risk patients with mild to moderately elevated TG levels (>2.3 and 200 and < 500 mg/dL) on a statin, treatment with either a fibrate or high-dose omega-3 fatty acids (icosapent ethyl) may be considered, weighing the benefit versus risks. Combination with fenofibrate may be considered for both macro- and microvascular benefits in patients with type 2 diabetes mellitus.ConclusionsThis guidance aims to improve real-world use of guideline-recommended combination lipid modifying treatment.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2021-05-01 |