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2024 Recommendations on the Optimal Use of Lipid-Lowering Therapy in Established Atherosclerotic Cardiovascular Disease and Following Acute Coronary Syndromes: A Position Paper of the International Lipid Expert Panel (ILEP)
M. Banach, Ž. Reiner, S. Surma, G. Bajraktari, A. Bielecka-Dabrowa, M. Bunc, I. Bytyçi, R. Ceska, AFG. Cicero, D. Dudek, K. Dyrbuś, J. Fedacko, Z. Fras, D. Gaita, D. Gavish, M. Gierlotka, R. Gil, I. Gouni-Berthold, P. Jankowski, Z. Járai, J....
Language English Country New Zealand
Document type Journal Article, Practice Guideline
NLK
ProQuest Central
from 2008-05-01 to 1 year ago
Nursing & Allied Health Database (ProQuest)
from 2008-05-01 to 1 year ago
Health & Medicine (ProQuest)
from 2008-05-01 to 1 year ago
- MeSH
- Acute Coronary Syndrome * blood drug therapy etiology MeSH
- Anticholesteremic Agents therapeutic use MeSH
- Atherosclerosis * blood complications drug therapy MeSH
- Hypolipidemic Agents * therapeutic use MeSH
- Cholesterol, LDL blood MeSH
- Humans MeSH
- Review Literature as Topic MeSH
- Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Practice Guideline MeSH
Atherosclerotic cardiovascular disease (ASCVD) and consequent acute coronary syndromes (ACS) are substantial contributors to morbidity and mortality across Europe. Fortunately, as much as two thirds of this disease's burden is modifiable, in particular by lipid-lowering therapy (LLT). Current guidelines are based on the sound premise that, with respect to low-density lipoprotein cholesterol (LDL-C), "lower is better for longer", and recent data have strongly emphasised the need for also "the earlier the better". In addition to statins, which have been available for several decades, ezetimibe, bempedoic acid (also as fixed dose combinations), and modulators of proprotein convertase subtilisin/kexin type 9 (PCSK9 inhibitors and inclisiran) are additionally very effective approaches to LLT, especially for those at very high and extremely high cardiovascular risk. In real life, however, clinical practice goals are still not met in a substantial proportion of patients (even in 70%). However, with the options we have available, we should render lipid disorders a rare disease. In April 2021, the International Lipid Expert Panel (ILEP) published its first position paper on the optimal use of LLT in post-ACS patients, which complemented the existing guidelines on the management of lipids in patients following ACS, which defined a group of "extremely high-risk" individuals and outlined scenarios where upfront combination therapy should be considered to improve access and adherence to LLT and, consequently, the therapy's effectiveness. These updated recommendations build on the previous work, considering developments in the evidential underpinning of combination LLT, ongoing education on the role of lipid disorder therapy, and changes in the availability of lipid-lowering drugs. Our aim is to provide a guide to address this unmet clinical need, to provide clear practical advice, whilst acknowledging the need for patient-centred care, and accounting for often large differences in the availability of LLTs between countries.
1st Department of Cardiology National and Kapodistrian University of Athens Athens Greece
Centre of Cardiology North Estonia Medical Centre Tallinn University of Technology Tallinn Estonia
Department of Cardiology University Hospital Centre Sestre Milosrdnice Zagreb Croatia
Department of Cardiology University Medical Centre Ljubljana Ljubljana Slovenia
Department of Family Medicine and Public Health University of Opole Opole Poland
Department of Gerontology and Geriatric PJ Safarik University Kosice Slovakia
Department of Internal Medicine School of Medicine University of Zagreb Zagreb Croatia
Dyslipidaemia Department Institute of Cardiology AMS of Ukraine Kiev Ukraine
Faculty of Medicine Vilnius University Vilnius Lithuania
Integrated Heart Center Shaare Zedek Medical Center Jerusalem Israel
Invasive Department Centre of Postgraduate Medical Education Warsaw Poland
Jagiellonian University Medical College Krakow Poland
Liverpool Centre for Cardiovascular Science Liverpool UK
Medical and Surgical Sciences Department Alma Mater Studiorum University of Bologna Bologna Italy
Medical Faculty University of Ljubljana Ljubljana Slovenia
MEDIPARK University Research Park PJ Safarik University Kosice Slovakia
School of Medicine European University Cyprus Nicosia Cyprus
School of Pharmacy and Biomolecular Sciences Liverpool John Moores University Liverpool UK
University of Medicine and Pharmacy Carol Davila University and Emergency Hospital Bucharest Romania
Vilnius University Hospital Santaros Klinikos Vilnius Lithuania
References provided by Crossref.org
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- $a Banach, Maciej $u Department of Preventive Cardiology and Lipidology, Medical University of Lodz (MUL), Rzgowska 281/289, 93-338, Lodz, Poland. maciej.banach@iczmp.edu.pl $u Division of Cardiology, Department of Medicine, Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA. maciej.banach@iczmp.edu.pl $u Department of Cardiology and Adult Congenital Heart Diseases, Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland. maciej.banach@iczmp.edu.pl $1 https://orcid.org/0000000166906874
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- $a 2024 Recommendations on the Optimal Use of Lipid-Lowering Therapy in Established Atherosclerotic Cardiovascular Disease and Following Acute Coronary Syndromes: A Position Paper of the International Lipid Expert Panel (ILEP) / $c M. Banach, Ž. Reiner, S. Surma, G. Bajraktari, A. Bielecka-Dabrowa, M. Bunc, I. Bytyçi, R. Ceska, AFG. Cicero, D. Dudek, K. Dyrbuś, J. Fedacko, Z. Fras, D. Gaita, D. Gavish, M. Gierlotka, R. Gil, I. Gouni-Berthold, P. Jankowski, Z. Járai, J. Jóźwiak, N. Katsiki, G. Latkovskis, SL. Magda, E. Margetic, R. Margoczy, O. Mitchenko, A. Durak-Nalbantic, P. Ostadal, G. Paragh, Z. Petrulioniene, F. Paneni, I. Pećin, D. Pella, A. Postadzhiyan, AP. Stoian, M. Trbusic, CA. Udroiu, M. Viigimaa, D. Vinereanu, C. Vlachopoulos, M. Vrablik, D. Vulic, PE. Penson, International Lipid Expert Panel (ILEP)
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- $a Atherosclerotic cardiovascular disease (ASCVD) and consequent acute coronary syndromes (ACS) are substantial contributors to morbidity and mortality across Europe. Fortunately, as much as two thirds of this disease's burden is modifiable, in particular by lipid-lowering therapy (LLT). Current guidelines are based on the sound premise that, with respect to low-density lipoprotein cholesterol (LDL-C), "lower is better for longer", and recent data have strongly emphasised the need for also "the earlier the better". In addition to statins, which have been available for several decades, ezetimibe, bempedoic acid (also as fixed dose combinations), and modulators of proprotein convertase subtilisin/kexin type 9 (PCSK9 inhibitors and inclisiran) are additionally very effective approaches to LLT, especially for those at very high and extremely high cardiovascular risk. In real life, however, clinical practice goals are still not met in a substantial proportion of patients (even in 70%). However, with the options we have available, we should render lipid disorders a rare disease. In April 2021, the International Lipid Expert Panel (ILEP) published its first position paper on the optimal use of LLT in post-ACS patients, which complemented the existing guidelines on the management of lipids in patients following ACS, which defined a group of "extremely high-risk" individuals and outlined scenarios where upfront combination therapy should be considered to improve access and adherence to LLT and, consequently, the therapy's effectiveness. These updated recommendations build on the previous work, considering developments in the evidential underpinning of combination LLT, ongoing education on the role of lipid disorder therapy, and changes in the availability of lipid-lowering drugs. Our aim is to provide a guide to address this unmet clinical need, to provide clear practical advice, whilst acknowledging the need for patient-centred care, and accounting for often large differences in the availability of LLTs between countries.
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