2024 Recommendations on the Optimal Use of Lipid-Lowering Therapy in Established Atherosclerotic Cardiovascular Disease and Following Acute Coronary Syndromes: A Position Paper of the International Lipid Expert Panel (ILEP).

Autor: Banach M; Department of Preventive Cardiology and Lipidology, Medical University of Lodz (MUL), Rzgowska 281/289, 93-338, Lodz, Poland. maciej.banach@iczmp.edu.pl.; Division of Cardiology, Department of Medicine, Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA. maciej.banach@iczmp.edu.pl.; Department of Cardiology and Adult Congenital Heart Diseases, Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland. maciej.banach@iczmp.edu.pl., Reiner Ž; Department of Cardiology and Adult Congenital Heart Diseases, Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland.; Division of Metabolic Diseases, Department of Internal Medicine, University Hospital Centre Zagreb, Zagreb, Croatia., Surma S; Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland., Bajraktari G; Clinic of Cardiology, University Clinical Centre of Kosova, Medical Faculty, University of Prishtina, Prishtina, Kosovo., Bielecka-Dabrowa A; Department of Cardiology and Adult Congenital Heart Diseases, Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland., Bunc M; Department of Cardiology, University Medical Centre Ljubljana, Ljubljana, Slovenia., Bytyçi I; Clinic of Cardiology, University Clinical Centre of Kosova, Medical Faculty, University of Prishtina, Prishtina, Kosovo., Ceska R; The 3rd Department of Internal Medicine-Metabolic Care and Gerontology, Charles University and University Hospital in Hradec Králové, Hradec Králové, Czech Republic., Cicero AFG; Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, Bologna, Italy., Dudek D; Jagiellonian University Medical College, Krakow, Poland., Dyrbuś K; 3rd Department of Cardiology, School of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland., Fedacko J; Department of Gerontology and Geriatric, PJ Safarik University, Kosice, Slovakia.; MEDIPARK-University Research Park, PJ Safarik University, Kosice, Slovakia., Fras Z; Division of Medicine, Department of Vascular Medicine, Centre for Preventive Cardiology, University Medical Centre Ljubljana, Ljubljana, Slovenia.; Medical Faculty, University of Ljubljana, Ljubljana, Slovenia., Gaita D; Department of Cardiology, University of Medicine and Pharmacy Victor Babes, Institute of Cardiovascular Diseases, Research Center IBCVTIM, Timisoara, Romania., Gavish D; Integrated Heart Center Shaare Zedek Medical Center, Jerusalem, Israel., Gierlotka M; Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, Opole, Poland., Gil R; Invasive Department, Centre of Postgraduate Medical Education, Warsaw, Poland., Gouni-Berthold I; Faculty of Medicine and University Hospital, Center for Endocrinology, Diabetes and Preventive Medicine, University of Cologne, Cologne, Germany., Jankowski P; Department of Internal Medicine and Geriatric Cardiology, Medical Centre for Postgraduate Education, Warsaw, Poland., Járai Z; Department of Cardiology, South-Buda Center Hospital, St. Imre University Teaching Hospital and Vascular and Heart Center of Semmelweis University, Budapest, Hungary., Jóźwiak J; Department of Family Medicine and Public Health, University of Opole, Opole, Poland., Katsiki N; Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece.; School of Medicine, European University Cyprus, Nicosia, Cyprus., Latkovskis G; Institute of Cardiology and Regenerative Medicine, University of Latvia and Pauls Stradins Clinical University Hospital, Riga, Latvia., Magda SL; University of Medicine and Pharmacy Carol Davila, University and Emergency Hospital, Bucharest, Romania., Margetic E; Clinic of Cardiovascular Diseases, University Hospital Center Zagreb, School of Medicine University of Zagreb, Zagreb, Croatia., Margoczy R; Department of General Cardiology, Middle Slovak Institute of Cardiovascular Diseases, Banska Bystrica, Slovakia., Mitchenko O; Dyslipidaemia Department, Institute of Cardiology, AMS of Ukraine, Kiev, Ukraine., Durak-Nalbantic A; Clinic for Heart, Blood Vessels and Rheumatic Diseases, Medical Faculty Sarajevo, University Clinical Center Sarajevo, Sarajevo, Bosnia and Herzegovina., Ostadal P; Department of Cardiology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic., Paragh G; Division of Metabolic Disease, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary., Petrulioniene Z; Faculty of Medicine, Vilnius University, Vilnius, Lithuania.; Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania., Paneni F; Department of Cardiology, Center for Translational and Experimental Cardiology (CTEC), University Hospital Zurich, Zurich, Switzerland., Pećin I; Department of Internal Medicine, School of Medicine, University of Zagreb, Zagreb, Croatia., Pella D; 2nd Department of Cardiology, Faculty of Medicine, Pavol Jozef Safarik University and East Slovak Institute of Cardiovascular Diseases, Kosice, Slovakia., Postadzhiyan A; Department of General Medicine, Emergency University Hospital 'St. Anna', Medical University of Sofia, Sofia, Bulgaria., Stoian AP; Department of Diabetes, Nutrition and Metabolic Diseases, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania., Trbusic M; Department of Cardiology, University Hospital Centre 'Sestre Milosrdnice', Zagreb, Croatia., Udroiu CA; Department of Cardiology and Cardiovascular Surgery, University and Emergency Hospital, Bucharest, Romania., Viigimaa M; Centre of Cardiology, North Estonia Medical Centre, Tallinn University of Technology, Tallinn, Estonia., Vinereanu D; University of Medicine and Pharmacy Carol Davila, University and Emergency Hospital, Bucharest, Romania., Vlachopoulos C; 1st Department of Cardiology, National and Kapodistrian University of Athens, Athens, Greece., Vrablik M; Third Department of Medicine-Department of Endocrinology and Metabolism of the First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic., Vulic D; Department of Internal Medicine, School of Medicine, University of Banja Luka, Banja Luka, Republic of Srpska.; Department of Medicine, Academy of Science and Arts, Republic of Srpska, Bosnia and Herzegovina, Banja Luka, Republic of Srpska., Penson PE; School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK.; Liverpool Centre for Cardiovascular Science, Liverpool, UK.
Jazyk: angličtina
Zdroj: Drugs [Drugs] 2024 Dec; Vol. 84 (12), pp. 1541-1577. Date of Electronic Publication: 2024 Nov 04.
DOI: 10.1007/s40265-024-02105-5
Abstrakt: Atherosclerotic cardiovascular disease (ASCVD) and consequent acute coronary syndromes (ACS) are substantial contributors to morbidity and mortality across Europe. Fortunately, as much as two thirds of this disease's burden is modifiable, in particular by lipid-lowering therapy (LLT). Current guidelines are based on the sound premise that, with respect to low-density lipoprotein cholesterol (LDL-C), "lower is better for longer", and recent data have strongly emphasised the need for also "the earlier the better". In addition to statins, which have been available for several decades, ezetimibe, bempedoic acid (also as fixed dose combinations), and modulators of proprotein convertase subtilisin/kexin type 9 (PCSK9 inhibitors and inclisiran) are additionally very effective approaches to LLT, especially for those at very high and extremely high cardiovascular risk. In real life, however, clinical practice goals are still not met in a substantial proportion of patients (even in 70%). However, with the options we have available, we should render lipid disorders a rare disease. In April 2021, the International Lipid Expert Panel (ILEP) published its first position paper on the optimal use of LLT in post-ACS patients, which complemented the existing guidelines on the management of lipids in patients following ACS, which defined a group of "extremely high-risk" individuals and outlined scenarios where upfront combination therapy should be considered to improve access and adherence to LLT and, consequently, the therapy's effectiveness. These updated recommendations build on the previous work, considering developments in the evidential underpinning of combination LLT, ongoing education on the role of lipid disorder therapy, and changes in the availability of lipid-lowering drugs. Our aim is to provide a guide to address this unmet clinical need, to provide clear practical advice, whilst acknowledging the need for patient-centred care, and accounting for often large differences in the availability of LLTs between countries.
Competing Interests: Declarations. Funding: No external funding was used in the preparation of this article. Conflict of interest: Dr. Banach has received research grant(s)/support from Amgen, Daiichi-Sankyo, Mylan/Viatris, and Sanofi, and has received honoraria and/or served as a consultant for Adamed, Amgen, Daiichi-Sankyo, Esperion, Kogen, KRKA, Lilly, MSD, Mylan/Viatris, NewAmsterdam Pharma, Novartis, Novo Nordisk, Polfarmex, Polpharma, Sanofi-Regeneron, Servier, Teva, and Zentiva. Dr. Reiner has received honoraria from Sanofi and Novartis. Dr. Cicero has received personal fees from Mylan-Viatris, Sharper, and Servier. Dr. Dyrbuś has received fee for scientific activities from Novartis, Sanofi-Aventis, and Amgen. Dr. Fedacko has received a consultancy fee from Sanofi, Amgen and Novo Nordisk, and a research grant from Pfizer. Dr. Fras has received grants and fees for scientific activities from Amgen, Krka, Novartis, Swix BioPharma, and Viatris. Dr. Gaita has received honoraria from Amgen, AstraZeneca, Bayer, Berlin Chemie, Biofarm, Boehringer Ingelheim, Galenica, GSK, Gedeon Richter, Krka, MSD, Novartis, Novo Nordisk, Pfizer, Sanofi, Servier, Terapia, Vifor Pharma, and Zentiva. Dr. Gierlotka reports honoraria from Sanofi, Novartis, Bayer, Amgen, Novo Nordisk, AstraZeneca, Servier. Dr. Gouni-Berthold has served as consultant and received honoraria from Akcea, Amgen, Daiichi-Sankyo, Novartis, Sanofi-Regeneron, Ultragenyx, and Amarin. Dr. Jankowski has received a research grant from Sanofi and has served as a consultant for Novartis, Servier, and Zentiva. Dr. Járai has served as a consultant for and received honoraria from Bayer, Berlin-Chemie, Boehringer Ingelheim, Egis, MSD, Novartis (Sandoz), Novo Nordisk, Pfizer, Richter Gedeon, Sanofi, Servier, and Teva. Dr. Latkovskis has given talks, attended conferences, received consultancy fees, and/or participated in trials sponsored by Abbott Laboratories, Amgen, AstraZeneca, Berlin-Chemie/Menarini, Bayer, Boehringer Ingelheim, GlaxoSmithKline, Grindex, KRKA, MSD, Mylan, Novartis, Novo Nordisk, Pfizer, Sanofi, Servier Laboratories, Siemens Laboratories, and Zentiva. Dr. Magda has received consultation fees from Novartis, Sanofi, and Servier. Dr. Margetic has received a fee for scientific activities from Novartis and Sanofi. Dr. Ostadal has received honoraria from Getinge, Abiomed, Edwards, Fresenius/Xenios, AstraZeneca, Bayer, Boehringer Ingelheim, Amgen, Sanofi, Servier, Novartis, Pfizer, AOP, and GSK. Dr Paragh has received lectures fees from Hungarian branches of Novartis, Richter Gedeon, and Sandoz. Dr. Paneni has received honoraria from Novo Nordisk. Dr. Pećin has received grants and fees for scientific activities from Amgen, Bayer, Novartis, and Sanofi. Dr. Pella has received grant support and honoraria from Sanofi, Amgen, MSD, Servier, Novartis, and Pfizer. Dr. Postadzhiyan reports fees for educational activities from Amgen, AstraZeneca, KRKA, Novartis, Servier, Teva, and Zentiva. Dr. Stoian has given lectures, received honoraria and research support, and participated in conferences, advisory boards, and clinical trials sponsored by pharmaceutical companies, from AstraZeneca, Amgen, Boehringer Ingelheim, Coca-Cola, Eli Lilly, Merck, Medtronic, MSD, Medochemie, Novo Nordisk, Novartis, Roche Diagnostics, Servier, Sandoz, and Sanofi. Dr. Trbusic has received a fee for scientific activities from Novartis and Sanofi. Dr. Udroiu has received a fee for scientific activities from AstraZeneca and Pfizer. Dr. Viigimaa reports fees for educational activities from Amgen, AstraZeneca, Novartis, Novo Nordisk, Menarini, Servier, and Swixx BioPharma. Dr. Vinereanu has received research grants and expert fees from Amgen, Sanofi, Novartis, and Servier. Dr. Vlachopoulos has received grants and fees for scientific activities from Amgen, Sanofi, and MSD. Dr. Vrablik has received personal fees from Abbott, Amgen, AstraZeneca, BMS, Genzyme, KRKA, MSD Idea, Novartis, Pfizer, and Sanofi-Regeneron. Dr. Vulic has received a fee for scientific activities from Sanofi. Dr. Penson owns four shares in AstraZeneca PLC and has received honoraria from Amgen and Sanofi and travel/accommodation reimbursement for events sponsored by AKCEA, Amgen, AMRYT, Link Medical, Mylan, and Napp. All other authors declare that they have no potential conflicts of interest that might be relevant to the contents of this article. Authors’ contributions: Dr. Banach: Conceptualisation; data curation; methodology; project administration; supervision; validation; visualisation; writing, reviewing, and editing; revisions; preparing the final version of the paper. Dr. Penson: Data curation; investigation; methodology; validation; visualisation; first draft preparation; reviewing and editing. Dr Surma: data curation, visualisation, draft figures preparations; reviewing and editing. Drs. Reiner, Bajraktari, Bielecka-Dabrowa, Bunc, Bytyçi, Ceska, Cicero, Dudek, Dyrbuś, Fedacko, Fras, Gaita, Gavish, Gierlotka, Gil, Gouni-Berthold, Jankowski, Járai, Jóźwiak, Katsiki, Latkovskis, Magda, Margetic, Margoczy, Mitchenko, Durak-Nalbantic, Ostadal, Paragh, Petrulioniene, Paneni, Pećin, Pella, Postadzhiyan, Stoian, Trbusic, Udroiu, Viigimaa, Vinereanu, Vlachopoulos, Vrablik, and Vulic: Investigation, methodology; validation; writing, reviewing, and editing; final revisions and approval. Data availability statement: Data sharing is not applicable to this article as no datasets were generated for this article. Ethics approval: Not applicable. Code availability: Not applicable. Consent to participate: Not applicable. Consent for publication: Not applicable.
(© 2024. The Author(s).)
Databáze: MEDLINE
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