2019 ESC/EAS guidelines for dyslipidemia management

New guidelines for management of dyslipidemia: lipid modification to reduce cardiovascular risks, were published in August 2019 by the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS).

These provide important new guidance for patient management, which should enable clinicians to efficiently and safely reduce CV risk through lipid modification.

Based on the latest results of the IMPROVE-IT and the Fourier and Odyssey Outcome study, significantly lower therapeutic target values were defined for LDL cholesterol (LDL-C) than previously for different cardiovascular risk groups.

Among others, the risk group includes patients suffering from diabetes mellitus, patients showing severe CKD (chronic kidney disease): eGFR < 30 mL/min/1.73 m and familial hypercholesterolemia individuals.

For patients at very high risk for new or recurrent cardiovascular events, the aim is to achieve an LDL-C target value of 55 mg/dl (1.4 mmol/L) and a reduction of at least 50%.

Briefly summarized, the guideline emphasizes the importance of lowering LDL-C concentrations significantly in case of cardiovascular risk or cardiovascular events. Lipid-lowering therapy should be applied as early and consistently as possible. An additional determination of Lp(a), at least once, should be performed to better assess the cardiovascular risk profile. Of course, all other risk factors, such as high blood pressure and diabetes mellitus, as well as other factors influencing the risk, such as depression or HIV medication, should also be taken into consideration and treated accordingly.

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Publication in full

European Heart Journal, Volume 41, Issue 1, 1 January 2020, Pages 111-188, doi.org/10.1093/eurheartj/ehz455

Atherosclerosis, Volume 290, November 2019, Pages p1-226 doi.org/10.1016/j.atherosclerosis.2019.08.014