Hypercholesterinämie – Wo stehen wir heute? Wo wollen wir hin?

Abstract

Hypercholesterolemia is one of the major modifiable risk factors for the development of atherosclerosis. Increasing LDL cholesterol is associated with an increased risk of developing cardiovascular diseases as well as cardiovascular ischemic complications. Studies with statins and ultimately with ezetimibe have been able to impressively demonstrate that lowering LDL cholesterol contributes to a significant reduction of cardiovascular ischemic complications.Based on the results of randomized trials for lipid lowering, the practice guidelines developed by the professional societies have defined LDL cholesterol goals. High-risk patients, such as patients with clinically manifest cardiovascular disease, type 2 diabetes, type 1 diabetes with organ damage, moderate or severe chronic kidney disease or a risk of SCORE ≥10 %, should reach LDL cholesterol values <70 mg/dl. Data from observational trials demonstrated that in daily practice only about 20 % of treated high-risk patients reached this recommended LDL cholesterol goal. The therapeutic options are not yet exhausted; patients are treated mainly with low or at most average statin dosages. There should be more potent and high-dose statins used as well as the combination therapy of statin and ezetimibe to achieve the recommended LDL cholesterol goals. Specific cardiac rehabilitation and prevention programs with regular benchmarking could support improved goal-achievement. The new therapeutic option of PCSK9 inhibitors, which significantly and safely lower LDL cholesterol on top of statins and ezetimibe, is currently investigated in large randomized outcome trials.

Laborvizsgálat jelentősége implantációs betegeknél

“…Ezekben az esetekben gyakrabban fordul elő 5 mm-nél nagyobb szondázási mélység és magasabb a szondázáskor jelentkező vérzés előfordulása [1]. A hi per li pi dé mia hozzájárul az atheroszklerózis és az oszteoporózis kialakulásához, így károsítva a kapillárisokat és a csontszerkezetet [24]. Ezáltal negatívan hat a pe ri im plan tá ris szövetek lokális immunreakciójára és az im plan táció hosszútávú sikeressége során nélkülözhetetlen csontintegrációra [25].…”