p.4 抽出テキスト

............................................................................................................................................................................. 9.10.3 Retinal vascular disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161 9.10.4 Secondary prevention in patients with abdominal aortic aneurysm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161 9.10.5 Renovascular atherosclerosis . . . . . . . . . . . . . . . . . . . . . . . . . . 161 9.11 Other special populations at risk of atherosclerotic cardiovascular disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161 10 Inflammation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161 11 Monitoring of lipids and enzymes in patients on lipid-lowering therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162 12 Cost-effectiveness of cardiovascular disease prevention by lipid modification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162 13 Strategies to encourage adoption of healthy lifestyle changes and adherence to lipid-modifying therapies . . . . . . . . . . . . . . . . 166 14 Key messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166 15 Gaps in evidence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167 16 Evidence-based ‘to do’ and ‘not to do’ messages from the Guidelines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168 17 Supplementary data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170 18 Appendix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170 19 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171

Tables of Recommendations

Recommendations for cardiovascular imaging for risk assessment of atherosclerotic cardiovascular disease . . . . . . . . . . . . . . . 127 Recommendations for cardiovascular disease risk estimation . . . . . . . 127 Recommendations for lipid analyses for cardiovascular disease risk estimation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131 Recommendations for treatment goals for low-density lipoprotein cholesterol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132 Recommendations for pharmacological low-density lipoprotein cholesterol lowering . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145 Recommendations for drug treatment of patients with hypertriglyceridaemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148 Recommendations for the detection and treatment of patients with heterozygous familial hypercholesterolaemia . . . . . . . . . . . . . . . . . 150 Recommendations for the treatment of dyslipidaemias in older people (aged >65 years) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153 Recommendations for the treatment of dyslipidaemias in diabetes mellitus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155 Recommendations for lipid-lowering therapy in veryhigh-risk patients with acute coronary syndromes . . . . . . . . . . . . . . . . . . 157 Recommendations for lipid-lowering therapy in very-high-risk patients undergoing percutaneous coronary intervention . . . . . . . . . . 157 Recommendations for lipid-lowering therapy for prevention of atherosclerotic cardiovascular disease events in patients with prior ischaemic stroke . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158 Recommendations for the treatment of dyslipidaemias in chronic heart failure or valvular heart diseases . . . . . . . . . . . . . . . . . . . . . 159 Recommendations for lipid management in patients with moderate to severe (Kidney Disease Outcomes Quality Initiative stages 35) chronic kidney disease . . . . . . . . . . . . . . . . . . . . . . . 159 Recommendations for low-density lipoprotein lowering in solid organ transplant patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160 Recommendations for lipid-lowering drugs in patients with peripheral arterial disease (including carotid artery disease) . . . . . . . . . 161 List of tables

Table 1 Classes of recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117 Table 2 Levels of evidence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117 Table 3 New recommendations, and new and revised concepts . . . . 119 Table 4 Cardiovascular risk categories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125 Table 5 Intervention strategies as a function of total cardiovascular risk and untreated low-density lipoprotein cholesterol levels . . . . . . . 126 Table 6 Physical and chemical characteristics of human plasma lipoproteins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128 Table 7 Treatment targets and goals for cardiovascular disease prevention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133 Table 8 Impact of specific lifestyle changes on lipid levels . . . . . . . . . . . 134 Table 9 Food choices to lower low-density lipoprotein cholesterol and improve the overall lipoprotein profile . . . . . . . . . . . . . 135 Table 10 Drugs potentially interacting with statins metabolized by cytochrome P450 3A4 leading to increased risk of myopathy and rhabdomyolysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139 Table 11 Genetic disorders of lipoprotein metabolism . . . . . . . . . . . . . 149 Table 12 Dutch Lipid Clinic Network diagnostic criteria for familial hypercholesterolaemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149 Table 13 Summary of recommendations for monitoring lipids and enzymes in patients, before and on lipid-lowering therapy . . . . . . 163

List of figures

Figure 1 Systematic Coronary Risk Estimation chart for European populations at high cardiovascular disease risk . . . . . . . . . . . . . . . . . . . . . 122 Figure 2 Systematic Coronary Risk Estimation chart for European populations at low cardiovascular disease risk . . . . . . . . . . . . . . . . . . . . . . 123 Figure 3 Expected clinical benefit of low-density lipoprotein cholesterol-lowering therapies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146 Figure 4 Treatment goals and algorithm for low-density lipoprotein cholesterol-lowering according to cardiovascular disease risk . . . . . . . 147 Figure 5 Health impact pyramid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164 Figure 6 Absolute reductions in major vascular events with statin therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165

List of boxes

Box 1 How to use the risk estimation charts . . . . . . . . . . . . . . . . . . . . . . . 124 Box 2 Risk estimation charts for different countries . . . . . . . . . . . . . . . . 124 Box 3 Qualifiers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124 Box 4 Factors modifying Systematic Coronary Risk Estimation risks . 124 Box 5 Risk estimation: key messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125 Box 6 Management of dyslipidaemia in women . . . . . . . . . . . . . . . . . . . . . 152 Box 7 Summary of dyslipidaemia in metabolic syndrome and type 2 diabetes mellitus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154 Box 8 Key messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165 Box 9 Gaps in the evidence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165 Box 10 Methods for enhancing adherence to lifestyle changes . . . . . . 166

Abbreviations and acronyms ABI Anklebrachial index ACCELERATE Assessment of Clinical Effects of Cholesteryl Ester Transfer Protein Inhibition with Downloaded from academic.oup.com/eurheartj/article/41/1/111/5556353 by guest on 07 October 2026