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Document Reviewers: Christian Eugen Mueller, (ESC Review Co-ordinator) (Switzerland), Heinz Drexel, (EAS Review Co-ordinator) (Austria), Ana Abreu (Portugal), Marianna Adamo (Italy), Suleman Aktaa (United Kingdom), Folkert W. Asselbergs (Netherlands), Antonio Baldini (Italy), Giuseppe Boriani (Italy), Margarita Brida (Croatia), Marianne Brodmann (Austria), Edina Cenko (Italy), Nikolaos Dagres (Germany), Jörn Dopheide (Switzerland), Christoph Ebenbichler (Austria), Estelle Gandjbakhch (France), Diana A. Gorog (United Kingdom), Ioanna Gouni-Berthold (Germany), Luigina Guasti (Italy), Bettina Heidecker (Germany), Borja Ibanez (Spain), Stefan James (Sweden), Peter Juni (United Kingdom), Marta Kałużna-Oleksy (Poland), Konstantin A. Krychtiuk (Austria), Gregory Y.H. Lip (United Kingdom), Roberto Lorusso (Netherlands), Felix Mahfoud (Switzerland), Marco Metra (Italy), Inge Moelgaard (Denmark), João Morais (Portugal), Lis Neubeck (United Kingdom), Steven E. Nissen (United States of America), Elena Osto (Austria/Switzerland), Klaus G. Parhofer (Germany), Leopoldo Perez De Isla (Spain), Maurizio Pesce (Italy/Saudi Arabia), Zaneta Petrulioniene (Lithuania), Eva Prescott (Denmark), Ernst Rietzschel (Belgium), Bianca Rocca (Italy), Jose Fernando Rodriguez Palomares (Spain), Xavier Rossello (Spain), Anna Sannino (Germany), Anne Grete Semb (Norway), Jolanta M. Siller-Matula (Austria), Thenral Socrates (Switzerland), Felix C. Tanner (Switzerland), Johann Wojta (Austria), Alberto Zambon (Italy), and Katja Zeppenfeld (Netherlands)

All experts involved in the development of this Focused Update have submitted declarations of interest which are reported in a supplementary document to the Focused Update. See the European Heart Journal online or https://www.escardio.org/Guidelines for supplementary documents as well as evidence tables.

Disclaimer: The European Society of Cardiology (ESC) / European Atherosclerosis Society (EAS) Focused Update represents the views of the ESC and the EAS and was produced after careful consideration of the scientific and medical knowledge and the evidence available at the time of their publication. The ESC and the EAS are not responsible in the event of any contradiction, discrepancy and/or ambiguity between the ESC/EAS Focused Update and any other official recommendations or guidelines issued by the relevant public health authorities, in particular in relation to good use of healthcare or therapeutic strategies. Health professionals are encouraged to take the ESC/EAS Focused Update fully into account when exercising their clinical judgement, as well as in the determination and the implementation of preventive, diagnostic or therapeutic medical strategies; however, the ESC/EAS Focused Update does not override, in any way whatsoever, the individual responsibility of health professionals to make appropriate and accurate decisions in consideration of each patient’s health condition and in consultation with that patient and, where appropriate and/or necessary, the patient’s caregiver. Nor does the ESC/EAS Focused Update exempt health professionals from taking into full and careful consideration the relevant official updated recommendations or guidelines issued by the competent public health authorities, in order to manage each patient’s case in light of the scientifically accepted data pursuant to their respective ethical and professional obligations. It is also the health professional’s responsibility to verify the applicable rules and regulations relating to drugs and medical devices prior to making any clinical decision and to check whether a more recent version of this document exists. The ESC and the EAS warn readers that the technical language may be misinterpreted and decline any responsibility in this respect.

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Table of contents

1. Preamble .............................................................................................................. 4361 2. Introduction ....................................................................................................... 4363 3. Estimation of total cardiovascular risk and implications for dyslipidaemia management ............................................................................... 4363 4. New low-density lipoprotein cholesterol-lowering therapies ..... 4367 5. Combination of lipid-lowering therapies during index hospitalization for acute coronary syndromes ......................................... 4369 6. Lipoprotein(a) .................................................................................................... 4370 7. Hypertriglyceridaemia .................................................................................... 4371 8. Primary prevention in people with human immunodeficiency virus infection ..................................................................................................................... 4372 9. Patients with cancer at high or very high chemotherapy-related cardiovascular toxicity risk ................................................................................ 4373 10. Dietary supplements .................................................................................... 4373 11. Evidence tables ............................................................................................... 4374 12. Data availability statement ......................................................................... 4374 13. Author information ...................................................................................... 4374 14. Appendix ........................................................................................................... 4374 15. References ........................................................................................................ 4375 Downloaded from academic.oup.com/eurheartj/article/46/42/4359/8234482 by guest on 07 October 2026