A Narrative Review and Expert Panel Recommendations on Dyslipidaemia Management After Acute Coronary Syndrome in Countri
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REVIEW
A Narrative Review and Expert Panel Recommendations on Dyslipidaemia Management After Acute Coronary Syndrome in Countries Outside Western Europe and North America Ashraf Reda . Wael Almahmeed . Idit Dobrecky-Mery . Po-Hsun Huang . Ursulo Juarez-Herrera . Naresh Ranjith . Tobias Sayre . Miguel Urina-Triana Received: February 12, 2020 Ó The Author(s) 2020
ABSTRACT Patients who have experienced an acute coronary syndrome (ACS) are at very high risk of recurrent atherosclerotic cardiovascular disease (CVD) events. Dyslipidaemia, a major risk factor for CVD, is poorly controlled post ACS in countries outside Western Europe and North America, despite the availability of effective lipid-modifying therapies (LMTs) and guidelines governing their use. Recent guideline
Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.11973354. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12325020-01302-4) contains supplementary material, which is available to authorized users. A. Reda (&) Department of Cardiology, Menoufia University, 127 Mohamed Fareed Street, Babellouk, Cairo, Egypt e-mail: [email protected] W. Almahmeed Department of Cardiovascular Medicine, Cleveland Clinic, Abu Dhabi, UAE I. Dobrecky-Mery Intensive Cardiac Care Unit, Bnai Zion Hospital, Haifa, Israel P.-H. Huang Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
updates recommend that low-density lipoprotein cholesterol (LDL-C), the primary target for dyslipidaemia therapy, be reduced by C 50% and to \ 1.4 mmol/L (55 mg/dL) in patients at very high risk of CVD, including those with ACS. The high prevalence of CVD risk factors in some regions outside Western Europe and North America confers a higher risk of CVD on patients in these countries. ACS onset is often earlier in these patients, and they may be more challenging to treat. Other barriers to effective dyslipidaemia control include low awareness of the value of intensive lipid lowering in patients with ACS, physician non-adherence to guideline recommendations, and lack of efficacy of currently used LMTs. Lack of appropriate pathways to guide follow-up of patients with ACS post discharge and poor access to intensive medications are important factors limiting U. Juarez-Herrera National Institute of Cardiology, Mexico City, Mexico N. Ranjith Cardiovascular Research Centre, Durban, South Africa T. Sayre Doctor Evidence, Santa Monica, CA, USA M. Urina-Triana Cardiology Division, Faculty of Health Sciences, Simo´n Bolı´var University, Barranquilla, Colombia
Adv Ther
dyslipidaemia therapy in many countries. Opportunities exist to improve attainment of LDL-C targets by the use of country-specific treatment algorithms to promote adherence to guideline recommendations, medical education and greater prioritisation by healthcare systems of dyslipidaemia management in very high risk patients.
Keywords: Atherosclerosis; Acute coronary syndrome; Dyslipidaemia; LDL-C; PCSK9 i
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