The 2018 Cholesterol Management Guidelines: Topics in Secondary ASCVD Prevention Clinicians Need to Know.

{"article_title":"The 2018 Cholesterol Management Guidelines: Topics in Secondary ASCVD Prevention Clinicians Need to Know.","author":"Jia X, Al Rifai M, Birnbaum Y, Smith SC Jr, Virani SS","journal_title":"Current atherosclerosis reports","issn":"1534-6242","isbn":"","publication_date":"2019-04-02","volume":"21","issue":"6","first_page":"20","page_count":"","accession_number":"30941517","doi":"","publisher":"Springer","doctype":"Journal Article","subjects":"Anticholesteremic Agents therapeutic use; Atherosclerosis drug therapy; Cholesterol, LDL blood; Secondary Prevention; Aged; Antibodies, Monoclonal, Humanized pharmacology; Antibodies, Monoclonal, Humanized therapeutic use; Ezetimibe therapeutic use; Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use; Hypercholesterolemia drug therapy; Male; Middle Aged; PCSK9 Inhibitors","interest_area":["Cardiology"],"abstract":"Purpose of Review: The 2018 ACC\/AHA Multisociety blood cholesterol guidelines provide updated recommendations based on contemporary evidence on the management of serum cholesterol for the prevention of atherosclerotic cardiovascular disease (ASCVD) events. This review discusses clinically important topics in the new guidelines related to secondary ASCVD prevention. Recent Findings: Since the 2013 ACC\/AHA blood cholesterol guidelines, several large randomized control trials involving ezetimibe and proprotein convertase subtilisin\/kexin type 9 (PCSK9) inhibitors (evolocumab and alirocumab) have been published. The trials provided evidence that these non-statin, LDL-cholesterol lowering agents are efficacious in reducing risk for ASCVD events in patients with clinical ASCVD. The 2018 guidelines incorporate these new findings into updated clinical recommendations on therapeutic strategies related to the use of ezetimibe and PCSK9 inhibitors. The guidelines also recommend risk stratification of secondary prevention patients to identify those at very high-risk of ASCVD events as these patients would derive the most absolute risk reduction from the addition of non-statin therapies. While high-intensity statins remain the first-line treatment to prevent recurrent ASCVD events in secondary prevention patients, ezetimibe and PCSK9 inhibitors are evidence-based non-statin agents that can be used when residual on top of maximally tolerated statin therapy in patients deemed to be at very-high risk of recurrent ASCVD events.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=30941517","isPdfLink":true,"isSAML":false,"an":"30941517","number_other":"","type_pub":"","issn_electronic":"1534-6242","languages":"English","language":"eng","date_entry":"","date_update":"","titleSource":"Current atherosclerosis reports [Curr Atheroscler Rep] 2019 Apr 02; Vol. 21 (6), pp. 20. Date of Electronic Publication: 2019 Apr 02.","date_pub_cy":"","type_document":"","contract_publisher":"","authored_on":"2019-04-02","description":"Purpose of Review: The 2018 ACC\/AHA Multisociety blood cholesterol guidelines provide updated recommendations based on contemporary evidence on the management of serum cholesterol for the prevention of atherosclerotic cardiovascular disease (ASCVD) events. This review discusses clinically important topics in the new guidelines related to secondary ASCVD prevention.<br \/>Recent Findings: Since the 2013 ACC\/AHA blood cholesterol guidelines, several large randomized control trials involving ezetimibe and proprotein convertase subtilisin\/kexin type 9 (PCSK9) inhibitors (evolocumab and alirocumab) have been published. The trials provided evidence that these non-statin, LDL-cholesterol lowering agents are efficacious in reducing risk for ASCVD events in patients with clinical ASCVD. The 2018 guidelines incorporate these new findings into updated clinical recommendations on therapeutic strategies related to the use of ezetimibe and PCSK9 inhibitors. The guidelines also recommend risk stratification of secondary prevention patients to identify those at very high-risk of ASCVD events as these patients would derive the most absolute risk reduction from the addition of non-statin therapies. While high-intensity statins remain the first-line treatment to prevent recurrent ASCVD events in secondary prevention patients, ezetimibe and PCSK9 inhibitors are evidence-based non-statin agents that can be used when residual on top of maximally tolerated statin therapy in patients deemed to be at very-high risk of recurrent ASCVD events.","upload_link":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=30941517&authtype=shib&custid=ns346513&group=main&profile=eds","no_of_pages":"","authored_by":"Jia X, Al Rifai M, Birnbaum Y, Smith SC Jr, Virani SS","header":{"DbId":"mdl","DbLabel":"MEDLINE Ultimate","An":"30941517","RelevancyScore":"845","PubType":"Academic Journal","PubTypeId":"academicJournal","PreciseRelevancyScore":"845.369201660156"},"plink":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=30941517&authtype=shib&custid=ns346513&group=main&profile=eds","physicalDescription":{"Pagination":{"StartPage":"20"}},"additionalInfo":{"Authored_By":"Jia X, Al Rifai M, Birnbaum Y, Smith SC Jr, Virani SS","Journal_Info":"Publisher: Springer Country of Publication: United States NLM ID: 100897685 Publication Model: Electronic Cited Medium: Internet ISSN: 1534-6242 (Electronic) Linking ISSN: 15233804 NLM ISO Abbreviation: Curr Atheroscler Rep Subsets: MEDLINE","Publication_Type":"Journal Article; Practice Guideline; Review","Published_Date":"2019-04-02","Source":"Current atherosclerosis reports [Curr Atheroscler Rep] 2019 Apr 02; Vol. 21 (6), pp. 20. Date of Electronic Publication: 2019 Apr 02.","Languages":"English","Electronic_ISSN":"1534-6242","MeSH_Terms":"Secondary Prevention*, Anticholesteremic Agents\/*therapeutic use , Atherosclerosis\/*drug therapy , Cholesterol, LDL\/*blood, Aged ; Antibodies, Monoclonal, Humanized\/pharmacology ; Antibodies, Monoclonal, Humanized\/therapeutic use ; Ezetimibe\/therapeutic use ; Female ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors\/therapeutic use ; Hypercholesterolemia\/drug therapy ; Male ; Middle Aged ; PCSK9 Inhibitors","Subjects":"Aged, Antibodies, Monoclonal, Humanized pharmacology, Antibodies, Monoclonal, Humanized therapeutic use, Ezetimibe therapeutic use, Female, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Hypercholesterolemia drug therapy, Male, Middle Aged, PCSK9 Inhibitors, Anticholesteremic Agents therapeutic use, Atherosclerosis drug therapy, Cholesterol, LDL blood, Secondary Prevention","Title_Abbreviations":"Current atherosclerosis reports","Volume":"21"}}