2024+ILEP意见书：降脂治疗在已确诊的动脉粥样硬化性心血管疾病和随后的急性冠状动脉综合征中的最佳应用.pdfVIP

Drugs

/10.1007/s40265-024-02105-5

REVIEWARTICLE

2024Recommendationson

the

OptimalUseof

Lipid‑Lowering

Therapyin

EstablishedAtheroscleroticCardiovascularDisease

and

FollowingAcuteCoronarySyndromes:A

PositionPaper

of

the

InternationalLipidExpertPanel(ILEP)

Maciej

Banach

·Željko

Reiner

·Stanisław

Surma

·Gani

Bajraktari

·Agata

Bielecka‑Dabrowa

·Matjaz

Bunc,et

al.

[full

authordetailsattheendofthearticle]

Accepted:30September2024

©TheAuthor(s)2024

Abstract

Atheroscleroticcardiovasculardisease(ASCVD)andconsequentacutecoronarysyndromes(ACS)aresubstantialcontribu-

torstomorbidityandmortalityacrossEurope.Fortunately,asmuchastwothirdsofthisdisease’sburdenismodifable,in

particularbylipid-loweringtherapy(LLT).Currentguidelinesarebasedonthesoundpremisethat,withrespecttolow-

densitylipoproteincholesterol(LDL-C),“lowerisbetterforlonger”,andrecentdatahavestronglyemphasisedtheneed

foralso“theearlierthebetter”.Inadditiontostatins,whichhavebeenavailableforseveraldecades,ezetimibe,bempedoic

acid(alsoasfxeddosecombinations),andmodulatorsofproproteinconvertasesubtilisin/kexintype9(PCSK9inhibitors

andinclisiran)areadditionallyveryefectiveapproachestoLLT,especiallyforthoseatveryhighandextremelyhighcar-

diovascularrisk.Inreallife,however,clinicalpracticegoalsarestillnotmetinasubstantialproportionofpatients(even

in70%).However,withtheoptionswehaveavailable,weshouldrenderlipiddisordersararedisease.InApril2021,the

InternationalLipidExpertPanel(ILEP)publisheditsfrstpositionpaperontheoptimaluseofLLTinpost-ACSpatients,

whichcomplementedtheexistingguidelinesonthemanagementoflipidsinpatientsfollowingACS,whichdefnedagroup

of“extremelyhigh-risk”individualsandoutlinedscenarioswhereupfrontcombinationtherapyshouldbeconsideredto

improveaccess