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)

作者：Maciej Banach, Željko Reiner, Stanisław Surma, Gani Bajraktari, Agata Bielecka‐Dąbrowa, Matjaž Bunc, Ibadete Bytyçi, R Češka, Arrigo F.G. Cicero, Dariusz Dudek, Krzysztof Dyrbuś, Ján Fedačko, Zlatko Fras, Dan Gaiță, Dov Gavish, Marek Gierlotka, Robert Gil, Ioanna Gouni‐Berthold, Piotr Jankowski, Zoltán Járai, Jacek Jerzy Jozwiak, Niki Katsiki, Gustavs Latkovskis, Stefania Magda, Eduard Margetić, Roman Margoczy, Olena Mitchenko, Azra Durak-Nalbantić, Petr Ošťádal, György Paragh, Žaneta Petrulionienė, Francesco Paneni, Ivan Pećin, Daniel Pella, Arman Postadzhiyan, Anca Pantea Stoian, Matias Trbušić, Cristian Alexandru Udroiu, Margus Viigimaa, Dragoş Vinereanu, Charalambos Vlachopoulos, Michal Vrablı́k, Duško Vulić, Peter E. Penson, International Lipid Expert Panel (ILEP) · 发表于：Drugs · 年份：2024 · DOI：10.1007/s40265-024-02105-5 · 被引用次数：51 · 研究领域：Lipoproteins and Cardiovascular Health、Health Systems, Economic Evaluations, Quality of Life、Pharmaceutical Economics and Policy

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 L...