In this article, we propose an update of the recommendations concerning lipid-lowering treatment in cardiovascular prevention. Since the 2021 publication, new risk estimation and medication selection tools have been developed. Notable advances in risk assessment include the development of a specific score for Type 2 diabetic patients, and the promotion of lipoprotein(a) measurement, which brings a significant nuance to cardiovascular risk. Regarding new drugs, we have benefited from the arrival of bempedoic acid since 2022 in Belgium, which belongs to a new therapeutic class, and inclisiran, which has been added to the therapeutic class of treatments targeting PCSK9, as well as the extension of reimbursement conditions for evolocumab. We felt that this update was necessary, given the importance of these new developments in our daily cardiovascular prevention practice.
What is already known about the topic?
The 2021 European recommendations have introduced several important new elements to better identify the most at-risk patients, who will require our full attention in our daily practice.
What does this article bring up for us?
- Since its publication, new cardiovascular risk assessment tools and new lipid-lowering drugs have arrived on the market.
- We are also witnessing the re-emergence of a parameter that has been somewhat neglected over the past 30 years, but which is regaining its significance thanks to recent Mendelian epidemiological studies, as well as the potential arrival of new drugs: lipoprotein(a) or Lp(a).
Keywords
Cholesterol, cardiovascular prevention, cardiovascular disease, recommendations, statin