De Luca Leonardo, Riccio Carmine, Navazio Alessandro, Valente Serafina, Cipriani Manlio, Corda Marco, De Nardo Alfredo, Francese Giuseppina Maura, Napoletano Cosimo, Tizzani Emanuele, Roncon Loris, Caldarola Pasquale, Gulizia Michele Massimo, Gabrielli Domenico, Oliva Fabrizio, Colivicchi Furio
U.O.C. Cardiologia, Dipartimento di Scienze Cardio-Toraco-Vascolari, A.O. San Camillo Forlanini, Roma.
U.O.S.D. Follow-up del Paziente Post-Acuto, Dipartimento Cardio-Vascolare, A.O.R.N. Sant'Anna e San Sebastiano, Caserta.
G Ital Cardiol (Rome). 2023 Mar;24(3):229-240. doi: 10.1714/3980.39627.
Patients suffering from acute coronary syndromes (ACS) present a high risk of recurrence and new adverse cardiovascular events after hospital discharge. Elevated plasma LDL-cholesterol (LDL-C) levels have been shown to be a causal factor for the development of coronary heart disease, and robust clinical evidence has documented that a decrease of LDL-C levels correlates linearly with a reduction in cardiovascular events. Recent studies have also demonstrated the safety and efficacy of an early and significant reduction in LDL-C levels in patients with ACS.In this position paper, ANMCO proposes a decision algorithm on early adoption of lipid-lowering strategies at hospital discharge and short-term follow-up of patients with ACS, in the light of the multiple evidence generated in recent years on the treatment of hypercholesterolemia and the available therapeutic options, considering current reimbursement criteria.
患有急性冠状动脉综合征(ACS)的患者在出院后存在较高的复发风险和新的不良心血管事件风险。血浆低密度脂蛋白胆固醇(LDL-C)水平升高已被证明是冠心病发生的一个因果因素,有力的临床证据表明,LDL-C水平的降低与心血管事件的减少呈线性相关。最近的研究还证明了在ACS患者中早期显著降低LDL-C水平的安全性和有效性。在本立场文件中,意大利心脏病学会(ANMCO)根据近年来关于高胆固醇血症治疗的多项证据和可用的治疗选择,并考虑当前的报销标准,提出了一项关于在ACS患者出院时尽早采用降脂策略以及短期随访的决策算法。