[Lipid-lowering therapy in Europe and the United States - treat to target or fire and forget?].
The 2013 AHA/ ACC guidelines on the assessment of cardiovascular risk recommend high-dose statin treatment to reduce LDL-cholesterol (LDL-C) by at least 30-50% without suggesting a specific target value 1. Favoring a strict Evidence Based Medicine approach the authors focus on randomized clinical trials only and neglect a target value since none of the randomized trials has titrated statin therapy to a specific LDL-C concentration. This is in contrast to current European guidelines. This paradigm shift has created a lot of controversy and confusion due to the lacking opportunity to assess medication adherence and the addition of further lipid lowering therapy. Moreover, these new guidelines might discourage clinicians to individualize patient care.
Vanessa
V
Pfetsch
Veronika
V
Sanin
Wolfgang
W
Koenig
D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000097:blood / Q000517:prevention & control*; D008078:Cholesterol, LDL / Q000097:blood*; D003431:Cross-Cultural Comparison; D004305:Dose-Response Relationship, Drug; D019317:Evidence-Based Medicine; D005858:Germany; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000097:blood / Q000188:drug therapy*; D000091362:PCSK9 Inhibitors; D017410:Practice Guidelines as Topic; D057285:Precision Medicine; D016032:Randomized Controlled Trials as Topic; D014481:United States; D000071449:Proprotein Convertase 9
D000924:Anticholesteremic Agents; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000091362:PCSK9 Inhibitors; C472125:PCSK9 protein, human; D000071449:Proprotein Convertase 9