1. | Editorial Öner Özdoğan Page I |
2. | Introduction to 2019 ESC/EAS Guidelines for the Management of Dyslipidema Lale Tokgözoğlu doi: 10.5543/ucard.2019.25744 Pages 1 - 2 Abstract | |
3. | Risk scoring and primary prevention Öner Özdoğan doi: 10.5543/ucard.2019.69188 Pages 3 - 6 Prevention of atherosclerotic cardiovascular disease (CVD) for any individual is associated with his/her total CVD risk, and the greater the risk, the greater the intensity of treatment. Different guidelines use different risk assessment systems. An ideal risk score should be based on country-specific data. European guidelines for protection from CVDs recommend the use of the SCORE system because it can be recalibrated for different countries. Although primary prevention is not examined under a separate heading in this guideline, the entire guideline contains data on primary prevention. The treatment of dyslipidemia of all individuals, except for patients with documented atherosclerotic CVD (coronary artery disease, peripheral vascular disease, and stroke) compose primary prevention and primary prevention patients range from a very high risk group to a low risk group. In the treatment of primary prevention patients, high-intensity statin therapy up to the highest tolerable dose is recommended to achieve the goals set similarly to secondary prevention. If the target is not reached by statin, combination therapy is recommended. |
4. | Approach to secondary prevention patient in the 2019 European Society of Cardiology Dyslipidemia Guide Meral Kayıkçıoğlu doi: 10.5543/ucard.2019.98608 Pages 7 - 9 When we compare the most recent 2019 European Society of Cardiology Guidelines of Dyslipidemia Diagnosis and treatment, with the previous guidelines, we see that the main difference is the approach to dyslipidemia in the secondary prevention patients. In patients with atherosclerotic cardiovascular disease, which is defined as very high-risk group, the main goal of treatment is to reduce low-density lipoprotein cholesterol to the levels of <55 mg/dL. Herein, the recommendations of the new guidelines for secondary prevention are summarized. |
5. | Lipid lowering therapy in particular patient populations Barış Güngör doi: 10.5543/ucard.2019.09797 Pages 10 - 15 Dyslipidemia is a major risk factor for cardiovascular diseases. In daily practice, patients with different clinical settings such as acute coronary syndrome, familial hypercholesterolemia, diabetes mellitus, chronic renal failure are not uncommon. These patients require special evaluation regarding treatment strategy, choice of medications, drug-drug interactions and follow-up. Usually, these patients have not been adequately presented in large randomized controlled trials, thus it is hard to derive definite indications and treatment algorithms for this group of patients. European Society of Cardiology/the European Atherosclerosis Society 2019 guideline on dyslipidemia and lipid modification to reduce cardiovascular risk has provided detailed information on patients with different clinical setting and updated treatment recommendations. |
6. | Lipid therapy in young and elderly Ceyhun Ceyhan, Fatih Sivri doi: 10.5543/ucard.2019.65375 Pages 16 - 19 Atherosclerotic cardiovascular disease is steadily increasing in society. The presence and cumulative effects of dyslipidemia have been shown to be very important in the atherosclerotic process in previous studies. This demonstrates the importance of primary and secondary prevention regardless of the age of the patient. Families of individuals with familial dyslipidemia should be screened for early diagnosis and treatment. In elderly and pediatric patients, statin therapy should be initiated at low doses and gradually increased according to the target low density lipoprotein-cholesterol levels. |
7. | Statin intolerance Özcan Başaran doi: 10.5543/ucard.2019.09719 Pages 20 - 24 The importance of lipid lowering therapies has increased with the precise determination of the causal relationship of cholesterol with atherosclerosis. Especially the need for long-term statin use (the most effective and safest drugs to lower low density lipoprotein (LDL) cholesterol) has led to serious investigations regarding the side effects of statins. The most important side effects of statins are myopathy, new onset diabetes, and despite some conflicting results hemorrhagic stroke. The most common side effect is myopathy and it is the most common cause for statin discontinuation. This condition is also known as statin intolerance and is associated with increased cardiovascular events rate. Threfore, management strategies of this problem are becoming increasingly important. In this article, statin side effects are reviewed briefly and management strategies of statin side effects are summarized with a special focus on patients with myopathy. |
8. | Diet and lifestyle modifications Ümit Yaşar Sinan doi: 10.5543/ucard.2019.02996 Pages 25 - 29 Cardiovascular disease is still the leading cause of mortality and morbidity in Turkey as whole World. Diet, life style modification, and exercise have an important impact on prevention of atherosclerotic cardiovascular disease. 2019 European Cardiology Association and European Atherosclerosis Association Guidelines for the management of dyslipidemias emphasized the importance of diet and life style modification to reduce burden of cardiovascular risk. |
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