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One year after the ESC/EAS guidelines on cholesterol control. What's the new evidence? What's missing?

Maurizio Averna1, Alberico L Catapano2

  • 1Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialities, University of Palermo, Palermo, Italy.

European Journal of Internal Medicine
|November 3, 2021
PubMed

Insights

The 2019 ESC/EAS dyslipidemia guidelines emphasize lowering low-density lipoprotein (LDL) cholesterol to prevent cardiovascular disease. This review examines new evidence and future challenges for managing lipid levels and reducing cardiovascular risk.

Area of Science:

  • Cardiology
  • Lipidology
  • Atherosclerosis Research

Background:

  • The 2019 European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) guidelines prioritize low-density lipoprotein (LDL) and apolipoprotein B (apoB)-containing lipoproteins in atherosclerosis management.
  • Guidelines emphasize significant reduction of LDL cholesterol (LDL-C) to mitigate cardiovascular (CV) risk.

Purpose of the Study:

  • To review recent clinical trial evidence published since the 2019 ESC/EAS guidelines.
  • To identify and discuss challenges for future dyslipidemia management guidelines.

Main Methods:

  • Literature review of clinical trials published after 2019.
  • Analysis of current evidence regarding lipid management and cardiovascular risk reduction.

Main Results:

  • New evidence reinforces the causal link between LDL/apoB lipoproteins and atherosclerosis.
  • Updated recommendations highlight the necessity of potent LDL-C reduction strategies.
  • Several challenges persist for future guideline development in dyslipidemia management.

Conclusions:

  • Continued focus on LDL-C reduction is crucial for cardiovascular risk management.
  • Emerging data necessitates re-evaluation of current therapeutic targets and strategies.
  • Addressing remaining challenges will refine future guidelines for optimal patient outcomes.

Keywords:
Cardiovascular disease, DyslipidemiaGuidelinesLDL-C treatmentPrimary preventionSecondary prevention

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