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Practical guidance for combination lipid-modifying therapy in high- and very-high-risk patients: A statement from a European Atherosclerosis Society Task Force
M. Averna, M. Banach, E. Bruckert, H. Drexel, M. Farnier, D. Gaita, P. Magni, W. März, L. Masana, A. Mello E Silva, Z. Reiner, E. Ros, M. Vrablik, A. Zambon, JL. Zamorano, JK. Stock, LS. Tokgözoğlu, AL. Catapano
Language English Country Ireland
Document type Journal Article, Research Support, Non-U.S. Gov't
- MeSH
- Anticholesteremic Agents * adverse effects MeSH
- Atherosclerosis * drug therapy prevention & control MeSH
- Diabetes Mellitus, Type 2 * MeSH
- Cholesterol, LDL MeSH
- Humans MeSH
- Proprotein Convertase 9 MeSH
- Hydroxymethylglutaryl-CoA Reductase Inhibitors * therapeutic use MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
BACKGROUND AND AIMS: This European Atherosclerosis Society (EAS) Task Force provides practical guidance for combination therapy for elevated low-density lipoprotein cholesterol (LDL-C) and/or triglycerides (TG) in high-risk and very-high-risk patients. METHODS: Evidence-based review. RESULTS: Statin-ezetimibe combination treatment is the first choice for managing elevated LDL-C and should be given upfront in very-high-risk patients with high LDL-C unlikely to reach goal with a statin, and in primary prevention familial hypercholesterolaemia patients. A proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor may be added if LDL-C levels remain high. In high and very-high-risk patients with mild to moderately elevated TG levels (>2.3 and < 5.6 mmol/L [>200 and < 500 mg/dL) on a statin, treatment with either a fibrate or high-dose omega-3 fatty acids (icosapent ethyl) may be considered, weighing the benefit versus risks. Combination with fenofibrate may be considered for both macro- and microvascular benefits in patients with type 2 diabetes mellitus. CONCLUSIONS: This guidance aims to improve real-world use of guideline-recommended combination lipid modifying treatment.
CIBER Fisiopatología de la Obesidad y Nutrición Instituto de Salud Carlos 3 Madrid 28029 Spain
Clinical Institute of Medical and Chemical Laboratory Diagnostics Medical University of Graz Austria
Department of Cardiology Hacettepe University Faculty of Medicine Turkey
Department of Cardiology University Hospital Ramón y Cajal Carretera de Colmenar Madrid Spain
Department of Medicine DIMED University of Padua Padova and IRCCS MultiMedica Milan Italy
Drexel University College of Medicine Philadelphia PA USA
European Atherosclerosis Society Mässans Gata 10 SE 412 51 Gothenburg Sweden
Pitié Salpêtrière Hospital and Sorbonne University Cardio Metabolic Institute Paris France
Polish Mother's Memorial Hospital Research Institute in Lodz Lodz Poland
Private University of the Principality of Liechtenstein Triesen Liechtenstein
Sociedade Portuguesa de Aterosclerose Lisbon Portugal
Vorarlberg Institute for Vascular Investigation and Treatment Feldkirch Austria
References provided by Crossref.org
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- $a Averna, Maurizio $u Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialities, University of Palermo, Palermo, Italy
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- $a BACKGROUND AND AIMS: This European Atherosclerosis Society (EAS) Task Force provides practical guidance for combination therapy for elevated low-density lipoprotein cholesterol (LDL-C) and/or triglycerides (TG) in high-risk and very-high-risk patients. METHODS: Evidence-based review. RESULTS: Statin-ezetimibe combination treatment is the first choice for managing elevated LDL-C and should be given upfront in very-high-risk patients with high LDL-C unlikely to reach goal with a statin, and in primary prevention familial hypercholesterolaemia patients. A proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor may be added if LDL-C levels remain high. In high and very-high-risk patients with mild to moderately elevated TG levels (>2.3 and < 5.6 mmol/L [>200 and < 500 mg/dL) on a statin, treatment with either a fibrate or high-dose omega-3 fatty acids (icosapent ethyl) may be considered, weighing the benefit versus risks. Combination with fenofibrate may be considered for both macro- and microvascular benefits in patients with type 2 diabetes mellitus. CONCLUSIONS: This guidance aims to improve real-world use of guideline-recommended combination lipid modifying treatment.
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