Journal article
Practical guidance for combination lipid-modifying therapy in high- and very-high-risk patients: A statement from a European Atherosclerosis Society Task Force
Atherosclerosis, v 325, pp 99-109
May 2021
PMID: 33892925
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
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.
Evidence-based review.
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.
This guidance aims to improve real-world use of guideline-recommended combination lipid modifying treatment.
•This EAS Task Force gives practical guidance for combination lipid lowering therapy in high- and very-high-risk patients.•In patients unlikely to reach the LDL-C goal with a statin alone combination with ezetimibe is suggested as first choice.•A PCSK9 inhibitor may be added if LDL-C levels remain high.•For type 2 diabetes with high triglycerides on statin, fenofibrate may be considered for macro- and microvascular benefits.••High-dose icosapent ethyl may be also considered for high triglycerides on statin treatment, weighing benefit vs. risk.
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Details
- Title
- Practical guidance for combination lipid-modifying therapy in high- and very-high-risk patients: A statement from a European Atherosclerosis Society Task Force
- Creators
- Maurizio Averna - University of PalermoMaciej Banach - University of Zielona GóraEric Bruckert - Pitié-Salpêtrière HospitalHeinz Drexel - Drexel University, College of MedicineMichel Farnier - Université de BourgogneDan Gaita - Victor Babeș University of Medicine and Pharmacy TimișoaraPaolo Magni - MultiMedicaWinfried März - SYNLAB Academy, SYNLAB Holding Deutschland GmbH, and Medical Clinic V, Medical Faculty of Mannheim, University of Heidelberg, GermanyLuis Masana - Universitat Rovira i VirgiliAlberto Mello e SilvaZeljko Reiner - University Hospital Centre ZagrebEmilio Ros - Instituto de Salud Carlos IIIMichal Vrablik - Charles UniversityAlberto Zambon - MultiMedicaJose L. Zamorano - Hospital Universitario Ramón y CajalJane K. Stock - European Atherosclerosis SocietyLale S. Tokgözoğlu - Hacettepe UniversityAlberico L. Catapano (Corresponding Author) - MultiMedica
- Publication Details
- Atherosclerosis, v 325, pp 99-109
- Publisher
- Elsevier B.V
- Number of pages
- 11
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:000651615900014
- Scopus ID
- 2-s2.0-85104682235
- Other Identifier
- 991021860667304721
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- Collaboration types
- Industry collaboration
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems
- Peripheral Vascular Disease