title: A consensus statement on lipid management after acute coronary syndrome.
abstract: In patients admitted for acute coronary syndrome (ACS), the guidelines of the European Society of Cardiology give a Class I, Level A recommendation for the prescription of high-intensity statins to be initiated as early as possible, regardless of the low-density lipoprotein cholesterol (LDL-C) level. Although statins are widely prescribed after ACS, the intensity of therapy and the proportion of patients achieving target LDL-C values are often not in line with recommendations due to a lack of compliance with guidelines by the physicians, a lack of compliance with treatment or poor tolerance by patients, and poor dose adaptation. In this context, a group of French physicians came together to define strategies to facilitate and improve the management of lipid-lowering therapy after ACS. This paper outlines the scientific rationale for the use of statins at the acute phase of ACS, the utility of ezetimibe, the measurement of LDL-C during the course of ACS, the opportunities for detecting familial hypercholesterolaemia and the results of the consensus for the management of lipid-lowering therapy, illustrated in two decision-making algorithms.
authors.affiliation: 1 Department of Cardiology, EA3920, University Hospital Jean Minjoz, Besançon, France.
authors.forename: François
authors.initials: F
authors.lastname: Schiele
authors.affiliation: 2 Point Médical, Rond-Point de la Nation, Dijon, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Farnier
authors.affiliation: 3 CHU de Nantes-Hôpital Nord Laennec, Nantes, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Krempf
authors.affiliation: 4 Endocrinologie métabolisme et prevention cardiovasculaire, Institut E3M et IHU cardiométabolique, Groupe hospitalier Pitié-Salpétrière, Paris, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Bruckert
authors.affiliation: 5 Service de Cardiologie B, CHU Rangueil, Toulouse, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Ferrières
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000188:drug therapy*; D000465:Algorithms; D032921:Consensus; D003657:Decision Making; D019468:Disease Management; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood*
chemical_list: D000960:Hypolipidemic Agents; D008055:Lipids
keywords: Acute coronary syndrome; LDL cholesterol; ezetimibe; familial hypercholesterolaemia; lipid-lowering therapy; statins