Recommendations to improve lipid control. Consensus document of the Spanish Society of Cardiology

Area of Science:

• Cardiology
• Lipid Metabolism
• Preventive Medicine

Background:

• Suboptimal control of low-density lipoprotein cholesterol (LDL-C) in atherosclerotic cardiovascular disease (ASCVD) patients is linked to increased cardiovascular events.
• Current lipid-lowering therapies, including statins, ezetimibe, and PCSK9 inhibitors, are underutilized, preventing many patients from reaching LDL-C goals.
• The benefit of lipid-lowering therapy in secondary prevention is dependent on risk and time.

Purpose of the Study:

• To propose simple and feasible decision-making algorithms for managing LDL-C in patients with ischemic heart disease.
• To facilitate the achievement of LDL-C therapeutic goals in the majority of secondary prevention patients.
• To emphasize the risk- and time-dependent nature of therapeutic benefits in secondary prevention.

Main Methods:

• Development of three distinct, practical algorithms for clinical decision-making.
• Algorithms designed to encompass a wide range of clinical scenarios in ischemic heart disease.
• Focus on optimizing the use of available lipid-lowering therapies.

Main Results:

• The proposed algorithms aim to improve the timely attainment of LDL-C goals for most patients.
• Implementation of these algorithms is expected to enhance secondary prevention strategies.
• The algorithms provide a structured approach to intensify lipid-lowering therapy when needed.

Conclusions:

• Effective LDL-C control is essential for reducing cardiovascular outcomes in ASCVD patients.
• The proposed algorithms offer a practical framework to improve treatment intensification and goal achievement.
• Optimizing lipid management through these algorithms can significantly enhance secondary prevention efforts.