Neue AHA- und ACC-Leitlinie zur Risikoreduktion von Herz-Kreislauf-Erkrankungen durch Cholesterinsenkung: Stellungnahme der D•A•CH-Gesellschaft Prävention von Herz-Kreislauf-Erkrankungen e. V., der Österreichischen Atherosklerose Gesellschaft und der Arbeitsgruppe Lipide und Atherosklerose (AGLA) der Schweizer Gesellschaft für Kardiologie
Standard
Neue AHA- und ACC-Leitlinie zur Risikoreduktion von Herz-Kreislauf-Erkrankungen durch Cholesterinsenkung: Stellungnahme der D•A•CH-Gesellschaft Prävention von Herz-Kreislauf-Erkrankungen e. V., der Österreichischen Atherosklerose Gesellschaft und der Arbeitsgruppe Lipide und Atherosklerose (AGLA) der Schweizer Gesellschaft für Kardiologie. / Klose, G; Beil, F U; Dieplinger, H; von Eckardstein, A; Föger, B; Gouni-Berthold, I; Koenig, W; Kostner, G M; Landmesser, U; Laufs, U; Leistikow, F; März, W; Merkel, M; Müller-Wieland, D; Noll, G; Parhofer, K G; Paulweber, B; Riesen, W; Schaefer, J R; Steinhagen-Thiessen, E; Steinmetz, A; Toplak, H; Wanner, C; Windler, E.
In: INTERNIST, Vol. 55, No. 5, 05.2014, p. 601-606.Research output: SCORING: Contribution to journal › Other (editorial matter etc.) › Research
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Neue AHA- und ACC-Leitlinie zur Risikoreduktion von Herz-Kreislauf-Erkrankungen durch Cholesterinsenkung: Stellungnahme der D•A•CH-Gesellschaft Prävention von Herz-Kreislauf-Erkrankungen e. V., der Österreichischen Atherosklerose Gesellschaft und der Arbeitsgruppe Lipide und Atherosklerose (AGLA) der Schweizer Gesellschaft für Kardiologie
AU - Klose, G
AU - Beil, F U
AU - Dieplinger, H
AU - von Eckardstein, A
AU - Föger, B
AU - Gouni-Berthold, I
AU - Koenig, W
AU - Kostner, G M
AU - Landmesser, U
AU - Laufs, U
AU - Leistikow, F
AU - März, W
AU - Merkel, M
AU - Müller-Wieland, D
AU - Noll, G
AU - Parhofer, K G
AU - Paulweber, B
AU - Riesen, W
AU - Schaefer, J R
AU - Steinhagen-Thiessen, E
AU - Steinmetz, A
AU - Toplak, H
AU - Wanner, C
AU - Windler, E
N1 - Leitlinie, Stellungnahme
PY - 2014/5
Y1 - 2014/5
N2 - Guidelines for the reduction of cholesterol to prevent atherosclerotic vascular events were recently released by the American Heart Association and the American College of Cardiology. The authors claim to refer entirely to evidence from randomized controlled trials, thereby confining their guidelines to statins as the primary therapeutic option. The guidelines derived from these trials do not specify treatment goals, but refer to the percentage of cholesterol reduction by statin medication with low, moderate, and high intensity. However, these targets are just as little tested in randomized trials as are the cholesterol goals derived from clinical experience. The same applies to the guidelines of the four patient groups which are defined by vascular risk. No major statin trial has included patients on the basis of their global risk; thus the allocation criteria are also arbitrarily chosen. These would actually lead to a significant increase in the number of patients to be treated with high or maximum dosages of statins. Also, adhering to dosage regulations instead of cholesterol goals contradicts the principles of individualized patient care. The option of the new risk score to calculate lifetime risk up to the age of 80 years in addition to the 10-year risk can be appreciated. Unfortunately it is not considered in the therapeutic recommendations provided, despite evidence from population and genetic studies showing that even a moderate lifetime reduction of low-density lipoprotein (LDL) cholesterol or non-HDL cholesterol has a much stronger effect than an aggressive treatment at an advanced age. In respect to secondary prevention, the new American guidelines broadly match the European guidelines. Thus, the involved societies from Germany, Austria and Switzerland recommend continuing according to established standards, such as the EAS/ESC guidelines.
AB - Guidelines for the reduction of cholesterol to prevent atherosclerotic vascular events were recently released by the American Heart Association and the American College of Cardiology. The authors claim to refer entirely to evidence from randomized controlled trials, thereby confining their guidelines to statins as the primary therapeutic option. The guidelines derived from these trials do not specify treatment goals, but refer to the percentage of cholesterol reduction by statin medication with low, moderate, and high intensity. However, these targets are just as little tested in randomized trials as are the cholesterol goals derived from clinical experience. The same applies to the guidelines of the four patient groups which are defined by vascular risk. No major statin trial has included patients on the basis of their global risk; thus the allocation criteria are also arbitrarily chosen. These would actually lead to a significant increase in the number of patients to be treated with high or maximum dosages of statins. Also, adhering to dosage regulations instead of cholesterol goals contradicts the principles of individualized patient care. The option of the new risk score to calculate lifetime risk up to the age of 80 years in addition to the 10-year risk can be appreciated. Unfortunately it is not considered in the therapeutic recommendations provided, despite evidence from population and genetic studies showing that even a moderate lifetime reduction of low-density lipoprotein (LDL) cholesterol or non-HDL cholesterol has a much stronger effect than an aggressive treatment at an advanced age. In respect to secondary prevention, the new American guidelines broadly match the European guidelines. Thus, the involved societies from Germany, Austria and Switzerland recommend continuing according to established standards, such as the EAS/ESC guidelines.
KW - Anticholesteremic Agents/administration & dosage
KW - Atherosclerosis/blood
KW - Austria
KW - Cardiology/standards
KW - Diet Therapy/standards
KW - Humans
KW - Hypercholesterolemia/blood
KW - Practice Guidelines as Topic
KW - Risk Factors
KW - Switzerland
U2 - 10.1007/s00108-014-3492-z
DO - 10.1007/s00108-014-3492-z
M3 - Andere (Vorworte u.ä.)
C2 - 24770979
VL - 55
SP - 601
EP - 606
JO - INTERNIST
JF - INTERNIST
SN - 0020-9554
IS - 5
ER -