Windler E, Zyriax B-Chr
Preventive Medicine, University Heart Center, University Hospital Hamburg-Eppendorf, Martinistr. 52 - Bldg. N36, D-20246 Hamburg, Germany.
Atheroscler Suppl. 2015 May;18:176-9. doi: 10.1016/j.atherosclerosissup.2015.02.027.
Current guidelines of the European Society of Cardiology and the European Atherosclerosis Society (ESC/EAS), of the American College of Cardiology and the American Heart Association (ACC/AHA), and of the International Atherosclerosis Society (IAS) are all based on the same body of evidence, but come to strikingly different conclusions with regard to lipid lowering therapy. While the ESC/EAS guidelines assign appropriate treatments to distinct lipid disorders, the ACC/AHA guidelines focus exclusively on evidence from randomized controlled trials for statins, but lack advice for those lipid disorders without evidence from randomized trials. Thus, evidence based medicine in its strict sense may leave a clinically significant gap. In striking contrast, the position paper of the IAS suggests the most advanced evidence-based innovative concept of a goal of one and the same healthy cholesterol level for anyone.
欧洲心脏病学会和欧洲动脉粥样硬化学会（ESC/EAS）、美国心脏病学会和美国心脏协会（ACC/AHA）以及国际动脉粥样硬化学会（IAS）的现行指南均基于同一证据体系，但在降脂治疗方面得出了截然不同的结论。ESC/EAS指南针对不同的脂质紊乱分配了适当的治疗方法，而ACC/AHA指南仅关注他汀类药物随机对照试验的证据，对于那些缺乏随机试验证据的脂质紊乱则缺乏建议。因此，严格意义上的循证医学可能会留下一个具有临床意义的空白。与之形成鲜明对比的是，IAS的立场文件提出了一个最先进的基于证据的创新概念，即对任何人而言，健康胆固醇水平的目标都是相同的。
