Universität zu Köln

Krychtiuk, Konstantin A., Ahrens, Ingo, Drexel, Heinz, Halvorsen, Sigrun, Hassager, Christian, Huber, Kurt, Kurpas, Donata ORCID: 0000-0002-6996-8920, Niessner, Alexander, Schiele, Francois, Semb, Anne Grete, Sionis, Alessandro, Claeys, Marc J., Barrabes, Jose, Montero, Santiago, Sinnaeve, Peter, Pedretti, Roberto and Catapano, Alberico (2022). Acute LDL-C reduction post ACS: strike early and strike strong: from evidence to clinical practice. A clinical consensus statement of the Association for Acute CardioVascular Care (ACVC), in collaboration with the European Association of Preventive Cardiology (EAPC) and the European Society of Cardiology Working Group on Cardiovascular Pharmacotherapy. Eur. Heart J.-Acute Cardiovasc. Care, 11 (12). S. 939 - 950. OXFORD: OXFORD UNIV PRESS. ISSN 2048-8734

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Abstract

After experiencing an acute coronary syndrome (ACS), patients are at a high risk of suffering from recurrent ischaemic cardiovascular events, especially in the very early phase. Low density lipoprotein-cholesterol (LDL-C) is causally involved in atherosclerosis and a clear, monotonic relationship between pharmacologic LDL-C lowering and a reduction in cardiovascular events post-ACS has been shown, a concept termed 'the lower, the better'. Current ESC guidelines suggest an LDL-C guided, step-wise initiation and escalation of lipid-lowering therapy (LLT). Observational studies consistently show low rates of guideline-recommended LLT adaptions and concomitant low rates of LDL-C target goal achievement, leaving patients at residual risk, especially in the vulnerable post-ACS phase. In addition to the well-established 'the lower, the better' approach, a 'strike early and strike strong' approach in the early post-ACS phase with upfront initiation of a combined lipid-lowering approach using high-intensity statins and ezetimibe seems reasonable. We discuss the rationale, clinical trial evidence and experience for such an approach and highlight existing knowledge gaps. In addition, the concept of acute initiation of PCSK9 inhibition in the early phase is reviewed. Ultimately, we focus on hurdles and solutions to provide high-quality, evidence-based follow-up care in post-ACS patients.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Krychtiuk, Konstantin A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ahrens, Ingo UNSPECIFIED UNSPECIFIED UNSPECIFIED Drexel, Heinz UNSPECIFIED UNSPECIFIED UNSPECIFIED Halvorsen, Sigrun UNSPECIFIED UNSPECIFIED UNSPECIFIED Hassager, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Huber, Kurt UNSPECIFIED UNSPECIFIED UNSPECIFIED Kurpas, Donata UNSPECIFIED orcid.org/0000-0002-6996-8920 UNSPECIFIED Niessner, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Schiele, Francois UNSPECIFIED UNSPECIFIED UNSPECIFIED Semb, Anne Grete UNSPECIFIED UNSPECIFIED UNSPECIFIED Sionis, Alessandro UNSPECIFIED UNSPECIFIED UNSPECIFIED Claeys, Marc J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Barrabes, Jose UNSPECIFIED UNSPECIFIED UNSPECIFIED Montero, Santiago UNSPECIFIED UNSPECIFIED UNSPECIFIED Sinnaeve, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Pedretti, Roberto UNSPECIFIED UNSPECIFIED UNSPECIFIED Catapano, Alberico UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-696048
DOI:	10.1093/ehjacc/zuac123
Journal or Publication Title:	Eur. Heart J.-Acute Cardiovasc. Care
Volume:	11
Number:	12
Page Range:	S. 939 - 950
Date:	2022
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	2048-8734
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ACUTE CORONARY SYNDROME; ACUTE MYOCARDIAL-INFARCTION; SUBTILISIN/KEXIN TYPE 9; LIPID-LOWERING THERAPY; STATIN THERAPY; FAMILIAL HYPERCHOLESTEROLEMIA; ATHEROSCLEROSIS SOCIETY; 000 PARTICIPANTS; MUSCLE SYMPTOMS; CHOLESTEROL Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/69604