Official journal of the Slovak Society of Cardiology,
Slovak Society of Hypertension and Slovak Association for Cardiac Arrhythmias

Cardiology Letters 2024, 33(4):259-265

Hypolipidemic therapy in the secondary prevention of cardiovascular events with regard to European guidelines and Slovak indication restrictions

Ivana Šoóšová
Ambulantné oddelenie NÚSCH, a. s., Bratislava, Slovenská republika

Hypercholesterolemia is one of the most important modifiable risk factors for atherosclerotic cardiovascular diseases. Reducing lifetime exposure to LDL-cholesterol significantly reduces cardiovascular risk. Current guidelines suggest lower LDL-C target values, especially in secondary prevention. In patients with documented atherosclerotic cardiovascular disease, i.e. persons with a very high cardiovascular risk, the target value for LDL-C is at least <1.4 mmol/l. Statins are a basic component of almost all hypolipidemic strategies. In the last decade, we have witnessed progress in non-statin therapies, which allows for more intensive lowering of LDL-C levels and the expansion of treatment alternatives. The aim of the article is to provide brief information about the currently available medical treatment of hypercholesterolemia with regard to currently valid Slovak indication and prescription restrictions.

Keywords: hypolipidemic therapy; secondary prevention of cardiovascular diseases; guidelines; indication and prescription restrictions

Published: April 1, 2024  Show citation

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Šoóšová I. Hypolipidemic therapy in the secondary prevention of cardiovascular events with regard to European guidelines and Slovak indication restrictions. Cardiology Letters. 2024;33(4):259-265.
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References

  1. Ference BA, Ginsberg HN, Graham I, Ray KK, Packard ChJ, Bruckert E, et al. Low-density lipoproteins cause atherosclerotic cardiovascular disease. 1. Evidence from genetic, epidemiologic, and clinical studies. A consensus statement from the European Atherosclerosis Society Consensus Panel. Eur Heart J 2017;38:2459-2472. doi: 10.1093/eurheartj/ehx144 Go to original source...
  2. Gencer B, Marston NA, Im K, Cannon ChP, Sever P, Keech A, et al. Efficacy and safety of lowering LDL cholesterol in older patients: a systematic review and meta-analysis of randomised controlled trials. Lancet 2020;396:1637-1643. doi: 10.1016/S0140-6736:32332-1. Go to original source...
  3. Mach F, Baigent C, Catapano AL, Koskinas KC, Casula M, Badimon L, et al. ESC Scientific Document Group. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J 2020;41:111-188. doi: 10.1093/eurheartj/ehz455 Go to original source...
  4. Visseren FLJ, Mach F, Smulders YM, Carballo D, Koskinas KC, Bäcket M, et al. ESC Scientific Document Group. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice: Developed by the Task Force for cardiovascular disease prevention in clinical practice with representatives of the European Society of Cardiology and 12 medical societies With the special contribution of the European Association of Preventive Cardiology (EAPC). Eur Heart J 2021;42:3227-3337. doi: 10.1093/eurheartj/ehab484 Go to original source...
  5. Mann DM, Woodward M, Muntner P, Falzon L, Kronishet I. Predictors of nonadherence to statins: A systematic review and meta-analysis. Ann Pharm 2010;44:1410-1421. doi: 10.1345/aph.1P150 Go to original source...
  6. Danchin N, Almahmeed W, Al-Rasadi K, Azuri J, Berrah A, Cuneo CA, et al. Achievement of low-density lipoprotein cholesterol goals in 18 countries outside Western Europe: The International ChoLesterol management Practice Study (ICLPS). Eur J Prev Cardiol 2018;25:1087-1094. doi: 10.1177/2047487318777079 Go to original source...
  7. Cannon CP, Blazing MA, Giugliano RP, McCagg A, White JA, Theroux P, et al. IMPROVE-IT Investigators. Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes. N Engl J Med 2015;372:2387-2397. doi: 10.1056/NEJMoa1410489 Go to original source...
  8. Bays HE, Davidson MH, Massaad R, Flaim D, Lowe RS, Tershakovec AM, et al. Safety and efficacy of ezetimibe added on to rosuvastatin 5 or 10 mg versus up-titration of rosuvastatin in patients with hypercholesterolemia (the ACTE Study). Am J Cardiol 2011;108:523-530. doi: 10.1016/j.amjcard.2011.03.079 Go to original source...
  9. Evolocumab PROFICIO Program - Program to Reduce LDL-C and Cardiovascular Outcomes Following Inhibition of PCSK9 In Different POpulations. https://www.expo.acc.org/ACC20/custom/uploads/pdf/PROFICIO%20CV%20Program%20Overall%20Booklet%20(1)_100057.pdf
  10. Ortona S, Barisione C, Ferrari PF, Palombo D, Pratesi G. PCSK9 and Other Metabolic Targets to Counteract Ischemia/Reperfusion Injury in Acute Myocardial Infarction and Visceral Vascular Surgery. J Clin Med 2022;11:3638. doi: 10.3390/jcm11133638 Go to original source...
  11. Sabatine MS, Giugliano RP, Keech AC, Honarpour N, Wiviott SD, Murphy SA, et al. FOURIER Steering Committee and Investigators. Evolocumab and clinical outcomes in patients with cardiovascular disease. N Engl J Med 2017;376:1713-1722. doi: 10.1056/NEJMoa1615664 Go to original source...
  12. Schwartz GG, Steg PG, Szarek M, Bhatt DL, Bittner VA, Diaz R, et al. ODYSSEY OUTCOMES Committees and Investigators. Alirocumab and cardiovascular outcomes after acute coronary syndrome. N Engl J Med 2018;379:2097-2107. doi: 10.1056/NEJMoa1801174 Go to original source...
  13. Libby P, Aikawa M. Stabilization of atherosclerotic plaques: New mechanisms and clinical targets. Nat. Med. 2002;8:1257-1262. doi: 10.1038/nm1102-1257 Go to original source...
  14. Byrne RA, Rossello X, Coughlan JJ, Barbato E, Berry C, Chieffo A, et al. ESC Scientific Document Group. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J 2023;44:3720-3826. doi: 10.1093/eurheartj/ehad191 Go to original source...
  15. Tummala R, Gupta M, Devanabanda AR, Bandyopadhyay D, Aronow WS, Ray KK, et al. Bempedoic acid and its role in contemporary management of hyperlipidemia in atherosclerosis. Ann Med 2022;54:1287-1296. doi: 10.1080/07853890.2022.2059559 Go to original source...
  16. Nissen SE, Lincoff AM, Brennan D, Ray KK, Mason D, Kastelein JJP, et al. CLEAR Outcomes Investigators. Bempedoic acid and cardiovascular outcomes in statin-intolerant patients. N Engl J Med 2023;388:1353-1564. doi: 10.1056/NEJMoa2215024 Go to original source...
  17. Nicholls SJ, Nelson AJ, Lincoff AM, Brennan D, Ray KK, Cho L, et al. Impact of Bempedoic Acid on Total Cardiovascular Events. A Prespecified Analysis of the CLEAR Outcomes Randomized Clinical Trial. JAMA Cardiol 2024;9:245-253. doi:10.1001/jamacardio.2023.5155 Go to original source...
  18. Ray KK, Raal FJ, Kallend DG, Jaros MJ, Koenig W, Leiter LA, et al. ORION Phase III investigators. Inclisiran and cardiovascular events: a patient-level analysis of phase III trials. Eur Heart J 2023;44:129-138. https://doi.org/10.1093/eurheartj/ehac594 Go to original source...
  19. Zoznam kategorizovaných liekov. Indikačné obmedzenia. https://www.health.gov.sk/?zoznam-kategorizovanych-liekov