A meeting of European experts in cardiovascular (CV) disease and lipids was convened in Paris, France, on 10 November 2014 to discuss lipid profile, and in particular atherogenic dyslipidaemia (AD), and associated CV risk. Key points that were raised and discussed during the meeting are summarised in this paper, which also accounts for further discussion and agreement on these points by the group of experts. Elevated levels of low-density lipoprotein cholesterol (LDL-c) are commonly associated with a greater CV risk than low LDL-c levels, and are routinely managed with statins. However, even for patients controlled on statins and achieving low LDL-c levels, abnormal lipid profiles observed in some patients (i.e. elevated triglyceride levels, with/without low levels of high-density lipoprotein cholesterol [HDL-c]) have been linked to the presence of a residual CV risk. Therefore, it is recommended that both triglyceride and HDL-c levels be measured, to allow for the overall CV residual risk to be adequately managed. Favourable safety and clinical data support the combination of statins with other lipid-lowering agents, such as fenofibrate. Patients who have elevated triglyceride levels plus low levels of HDL-c are most likely to achieve clinical benefit from fenofibrate-statin combination therapy. In these patients with AD, achieving target non-HDL-c levels should be a key focus of CV risk management, and the use of non-HDL-c was advocated to provide a better measure of CV risk than LDL-c levels.

3rd Department of Internal Medicine 1st Medical Faculty Charles University Prague Czech Republic

Cardiology Department Policlínica Gipuzkoa San Sebastián Spain

Cardiology Unit Department of Medicine Karolinska University Hospital Stockholm Sweden

Clinica Medica Department of Medicine University of Padova Italy

Department of Advanced Biomedical Sciences Federico 2 University Naples Italy

Department of Cardiology and LTTA Centre University Hospital of Ferrara and Maria Cecilia Hospital GVM Care and Research E S Health Science Foundation Cotignola Italy

Department of Cardiology Ege University Medical School İzmir Turkey

Department of Cardiology Toulouse University School of Medicine Rangueil Hospital Toulouse France

Department of Endocrinology Diabetology Nutrition Jean Verdier Hospital APHP Paris Nord University CRNH IdF CINFO Bondy France

Department of Internal Medicine University of Ioannina Medical School Greece

Department of Pharmacological and Biomolecular Sciences University of Milan IRCCS Multimedica Milan Italy

Division of Endocrinology Department of Clinical and Experimental Medicine University of Parma and Azienda Ospedaliera Universitaria of Parma Italy

Hacettepe University Ankara Turkey

Hospital Egas Moniz Centro Hospitalar Lisboa Ocidental Lisbon Portugal

Hospital General Universitario Gregorio Marañón Facultad de Medicina de la Universidad Complutense Madrid Spain

Hospital Santa Cruz Centro Hospitalar de Lisboa Ocidental EPE Carnaxide Portugal

Iuliu Haţieganu University of Medicine and Pharmacy Cluj Napoca Romania

North Estonia Medical Centre Tallinn University of Technology Estonia

Point Médical Dijon France

University Alcalá de Henares Hospital Ramón y Cajal Madrid Spain

University Hospital Center School of Medicine University of Zagreb Croatia

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Current practice in identifying and treating cardiovascular risk, with a focus on residual risk associated with atherogenic dyslipidaemia