ESC/EAS Guidelines for the management of dyslipidaemias: The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS)

Abstract

Cardiovascular disease (CVD) due to atherosclerosis of the arterial vessel wall and to thrombosis is the foremost cause of premature mortality and of disability-adjusted life years (DALYs) in Europe, and is also increasingly common in developing countries.1 In the European Union, the economic cost of CVD represents annually E192 billion1 in direct and indirect healthcare costs. The main clinical entities are coronary artery disease (CAD), ischaemic stroke, and peripheral arterial disease (PAD). The causes of these CVDs are multifactorial. Some of these factors relate to lifestyles, such as tobacco smoking, lack of physical activity, and dietary habits, and are thus modifiable. Other risk factors are also modifiable, such as elevated blood pressure, type 2 diabetes, and dyslipidaemias, or non-modifiable, such as age and male gender. These guidelines deal with the management of dyslipidaemias as an essential and integral part of CVD prevention. Prevention and treatment of dyslipidaemias should always be considered within the broader framework of CVD prevention, which is addressed in guidelines of the Joint European Societies’ Task forces on CVD prevention in clinical practice.2 – 5 The latest version of these guidelines was published in 20075; an update will become available in 2012. These Joint ESC/European Atherosclerosis Society (EAS) guidelines on the management of dyslipidaemias are complementary to the guidelines on CVD prevention in clinical practice and address not only physicians [e.g. general practitioners (GPs) and cardiologists] interested in CVD prevention, but also specialists from lipid clinics or metabolic units who are dealing with dyslipidaemias that are more difficult to classify and treat.

Sex‐Based Differences in the Performance of the HEART Score in Patients Presenting to the Emergency Department With Acute Chest Pain

“…Dyslipidemia was scored when diagnosed previously by a physician or diagnosed during the index visit, according to the European Society of Cardiology/European Atherosclerosis Society guidelines 19. Hypertension was scored when reported in the medical history, when diagnosed during the index visit, or when the patient was treated for hypertension 20.…”

Efficacy and Safety of Alirocumab 150 mg Every 4 Weeks in Patients With Hypercholesterolemia Not on Statin Therapy: The ODYSSEY CHOICE II Study

“…Statins lower low‐density lipoprotein cholesterol (LDL‐C) by inhibiting 3‐hydroxy‐3‐methylglutaryl‐coenzyme A reductase and consistently reduce cardiovascular disease (CVD) risk by 30% to 40% 1, 2, 3. Therefore, statin therapy is currently the recommended standard‐of‐care treatment for lowering LDL‐C in patients at increased CVD risk 2, 3.…”

“…Therefore, statin therapy is currently the recommended standard‐of‐care treatment for lowering LDL‐C in patients at increased CVD risk 2, 3. In contrast to all major randomized controlled trials, which have found comparable rates of muscle adverse events (AEs) between statin and placebo arms,4, 5, 6 observational studies reported higher rates of statin‐associated muscle symptoms (SAMS) in 7% to 29% of patients 7.…”

Predictors of Nonuse of a High‐Potency Statin After an Acute Coronary Syndrome: Insights From the Stabilization of Plaques Using Darapladib‐Thrombolysis in Myocardial Infarction 52 (SOLID‐TIMI 52) Trial

“…However, enrollment in the SOLID‐ TIMI 52 trial occurred between 2009 and 2011, so neither factor would have affected statin use in the current study. Although some guidelines that were available at the time of the trial recommended the routine use of high‐potency statins in patients after ACS,7, 17, 18 other guidelines focused primarily on achieving LDL cholesterol concentrations <100 or <70 mg/dL in high‐risk patients 19, 20. We observed, however, that the use of high‐potency statins was also low in patients who had not achieved desired LDL cholesterol target goals.…”