What is New in the Most Recent Guidelines for the Management of Dyslipidemias of the European Society of Cardiology and the European Atherosclerosis Society?
| Autor: | Boško Skorić |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: | |
| Zdroj: | Cardiologia Croatica Volume 16 Issue 1-2 |
| ISSN: | 1848-5448 1848-543X |
| Popis: | Posljednje smjernice o liječenju dislipidemija Europskoga kardiološkog društva i Europskoga društva za aterosklerozu došle su nakon dvaju velikih istraživanja koja su dokazala učinkovitost inhibitora proprotein konvertaze subtilizin/keksin tipa 9 (PCSK9i), ali i ključnu činjenicu da svako dodatno sniženje LDL kolesterola smanjuje povišeni kardiovaskularni rizik, odnosno da ne postoji preniska ciljna koncentracija LDL kolesterola u krvi. Navedeno se odrazilo na preporuku o mnogo nižim ciljnim vrijednostima LDL kolesterola, napose za osobe s visokim i vrlo visokim kardiovaskularnim rizikom, zbog čega je prepoznata potreba za kombiniranjem statina s drugim hipolipemicima, prije svega ezetimiba, a zatim i PCSK9i. U liječenju osoba s visokim rizikom s hipertrigliceridemijom usprkos primjeni statina preporučene su omega-3 masne kiseline. Došlo je do nekih preinaka u kategorizaciji kardiovaskularnog rizika, prije svega u osoba sa šećernom bolešću i s obiteljskom hiperkolesterolemijom, a pridana je i veća važnost određivanju apolipoproteina B i lipoproteina(a) u preciznijoj procjeni kardiovaskularnog rizika. Sada nam preostaje uložiti znatan trud u to da navedene preporuke implementiramo u svakodnevnu kliničku praksu i tako dodatno smanjimo teret zbog kardiovaskularnih bolesti u populaciji. The most recent Guidelines for the management of dyslipidemias of the European Society of Cardiology and the European Atherosclerosis Society arrived after two major studies that demonstrated the efficiency of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i), as well as the key fact that every additional reduction of LDL cholesterol reduces increased cardiovascular risk, i.e. that there is no lower limit of target blood concentration of LDL cholesterol. The latter was reflected in the recommendation of significantly lower target values of LDL cholesterol, especially for people with high and very high cardiovascular risk, resulting in the recognition of the need to combine statins with other hypolipemic agents, primarily ezetimibe followed by PCSK9i. Omega-3 fatty acids are recommended for the treatment of high-risk patients with hypertriglyceridemia despite statin treatment. Some modifications were made to cardiovascular risk categories, primarily for patients with diabetes mellitus and familial hypercholesterolemia, and more importance has been assigned to determining apolipoprotein B and lipoprotein(a) for more precise assessment of cardiovascular risk. We are now tasked with investing significant efforts into implementing these recommendations in our daily clinical practice in order to further reduce the population burden of cardiovascular diseases. |
| Databáze: | OpenAIRE |
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