New European Society of Cardiology/European Atherosclerosis Society Guideline for the Management of Dyslipidemia

Chang Hee Jung

doi:10.12997/jla.2017.6.1.8

Journal List > J Lipid Atheroscler > v.6(1) > 1059593

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Jung: New European Society of Cardiology/European Atherosclerosis Society Guideline for the Management of Dyslipidemia

Review

Journal of Lipid and Atherosclerosis 2017; 6(1): 8-14.

Published online: 30 June 2017

DOI: https://doi.org/10.12997/jla.2017.6.1.8

New European Society of Cardiology/European Atherosclerosis Society Guideline for the Management of Dyslipidemia

Chang Hee Jung

Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Corresponding Author: Chang Hee Jung, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea. Tel: +82-2-3010-1418, Fax: +82-2-3010-6969, chjung0204@gmail.com

Received 23 May 2017 Revised 5 June 2017 Accepted 2 June 2017

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The management of dyslipidemia is one of the crucial components in the prevention of atherosclerotic cardiovascular disease. Recently, the task force for the management of dyslipidemias of the ESC (European Society of Cardiology) and the EAS (European Atherosclerosis Society) updated their clinical guideline for the first time in 5 years. Although the new guideline maintained the previous recommendations in almost every aspect, there were some updates and modifications in the risk categorization and therapeutic modalities. In this review, I'd like to summarize the updated recommendations and differences compared to the previous version.

Keywords: Dyslipidemia, Guideline, ESC, EAS

Figures and Tables

Table 1

The Difference in the Risk Stratification and Treatment Targets in LDL-C between 2011 and 2016 ESC/EAS Guidelines for the Management of Dyslipidemia

2016 ESC/EAS guidelines2	2011 ESC/EAS guideline1
Very high risk: established CVD; DM with target organ damage such as proteinuria or with a major associated risk factor such as smoking, hypertension, or dyslipidemia; severe CKD (eGFR <30 ml/min/1.73 m²); 10-year cardiovascular risk ≥10% Treatment targets: LDL-C <70 mg/dL or >50% reduction if LDL-C is between 70 and 135 mg/dL	Very high risk: established CVD; 10-year cardiovascular risk ≥10% DM with target organ damage such as microalbuminuria; moderate to severe CKD (eGFR <60 ml/min/1.73m²) Treatment targets: LDL-C <70 mg/dL or >50% reduction if this target is not reached, independently of baseline LDL-C
High risk: Markedly elevated single risk factor, such as cholesterol >310 mg/dl (eq, in FH) or blood pressure ≥180/110 mmHg; DM not included in the very high risk category); moderate CKD (eGFR 30-59 ml/min/1.73m²); 10-year cardiovascular risk ≥5% and <10% Treatment targets: LDL-C <100 mg/dL or >50% reduction if LDL-C between 100 and 200 mg/dL	High risk: Markedly elevated single risk factor, such as FH) or severe hypertension; 10-year cardiovascular risk ≥5% and <10% Treatment targets: LDL-C <100 mg/dL
Moderate or low risk (10-year cardiovascular risk <5%): LDL <115 mg/dL is treatment targets.	Moderate or low risk (10-year cardiovascular risk <5%): LDL <115 mg/dL is treatment targets.

CKD; chronic kidney disease, CVD; cardiovascular disease, DM; diabetes mellitus, EAS; European Atherosclerosis Society, eGFR; estimated glomerular filtration rate, ESC; European Society of Cardiology, FH; familial hypercholesterolemia, LDL-C; low-density lipoprotein-cholesterol

References

1. European Association for Cardiovascular Prevention & Rehabilitation. Reiner Z, Catapano AL, De Backer G, Graham I, Taskinen MR, et al. ESC/EAS Guidelines for the management of dyslipidaemias: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Eur Heart J. 2011; 32:1769–1818.

2. Catapano AL, Graham I, De Backer G, Wiklund O, Chapman MJ, Drexel H, et al. 2016 ESC/EAS Guidelines for the management of dyslipidaemias. Eur Heart J. 2016; 37:2999–3058.

3. Stone NJ, Robinson JG, Lichtenstein AH, Bairey Merz CN, Blum CB, Eckel RH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014; 129:S1–S45.

4. Ridker PM, Cook NR. Statins: new American guidelines for prevention of cardiovascular disease. Lancet. 2013; 382:1762–1765.

5. Pencina MJ, Navar-Boggan AM, D'Agostino RB Sr, Williams K, Neely B, Sniderman AD, et al. Application of new cholesterol guidelines to a population-based sample. N Engl J Med. 2014; 370:1422–1431.

6. HPS2-THRIVE Collaborative Group. Landray MJ, Haynes R, Hopewell JC, Parish S, Aung T, et al. Effects of extended-release niacin with laropiprant in high-risk patients. N Engl J Med. 2014; 371:203–212.

7. AIM-HIGH Investigators. Boden WE, Probstfield JL, Anderson T, Chaitman BR, Desvignes-Nickens P, et al. Niacin in patients with low HDL cholesterol levels receiving intensive statin therapy. N Engl J Med. 2011; 365:2255–2267.

8. SEC Working Group for the 2016 ESC Guidelines for the Management of Dyslipidemias 2016. Expert Reviewers for the ESC Guidelines for the Management of Dyslipidemias 2016. SEC Guidelines Committee. Comments on the 2016 ESC/EAS Guidelines for the management of dyslipidemias. Rev Esp Cardiol (Engl Ed). 2017; 70:72–77.

9. Cholesterol Treatment Trialists' (CTT) Collaboration. Baigent C, Blackwell L, Emberson J, Holland LE, Reith C, et al. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet. 2010; 376:1670–1681.

10. Preiss D, Seshasai SR, Welsh P, Murphy SA, Ho JE, Waters DD, et al. Risk of incident diabetes with intensive-dose compared with moderate-dose statin therapy: a metaanalysis. JAMA. 2011; 305:2556–2564.

11. Waters DD, Ho JE, Boekholdt SM, DeMicco DA, Kastelein JJ, Messig M, et al. Cardiovascular event reduction versus new-onset diabetes during atorvastatin therapy: effect of baseline risk factors for diabetes. J Am Coll Cardiol. 2013; 61:148–152.

12. Cannon CP, Blazing MA, Giugliano RP, McCagg A, White JA, Theroux P, et al. Ezetimibe added to statin therapy after acute coronary syndromes. N Engl J Med. 2015; 372:2387–2397.

13. Sabatine MS, Giugliano RP, Wiviott SD, Raal FJ, Blom DJ, Robinson J, et al. Efficacy and safety of evolocumab in reducing lipids and cardiovascular events. N Engl J Med. 2015; 372:1500–1509.

14. Robinson JG, Farnier M, Krempf M, Bergeron J, Luc G, Averna M, et al. Efficacy and safety of alirocumab in reducing lipids and cardiovascular events. N Engl J Med. 2015; 372:1489–1499.

15. Barter PJ, Caulfield M, Eriksson M, Grundy SM, Kastelein JJ, Komajda M, et al. Effects of torcetrapib in patients at high risk for coronary events. N Engl J Med. 2007; 357:2109–2122.

16. Lincoff AM, Nicholls SJ, Riesmeyer JS, Barter PJ, Brewer HB, Fox KA, et al. Evacetrapib and cardiovascular outcomes in high-risk vascular disease. N Engl J Med. 2017; 376:1933–1942.

17. Schwartz GG, Olsson AG, Abt M, Ballantyne CM, Barter PJ, Brumm J, et al. Effects of dalcetrapib in patients with a recent acute coronary syndrome. N Engl J Med. 2012; 367:2089–2099.

18. Reveal Collaborative Group. Landray MJ, Bowman L, Chen F, Sammons E, Hopewell JC, et al. Randomized Evaluation of the Effects of Anacetrapib through Lipid-modification (REVEAL): a large-scale, randomized, placebo-controlled trial of the clinical effects of anacetrapib among people with established vascular disease: trial design, recruitment, and baseline characteristics. Am Heart J. 2017; 187:182–190.

19. Tonelli M, Wanner C. Kidney Disease: Improving Global Outcomes Lipid Guideline Development Work Group Members. Lipid management in chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2013 clinical practice guideline. Ann Intern Med. 2014; 160:182.

TOOLS

Similar articles