This consensus statement provides practical algorithms to improve adherence to guideline-directed lipid-lowering therapy following acute coronary syndrome.
Enables optimized post-ACS lipid-lowering adherence now; extends guidelines with practical decision algorithms for clinicians and validation studies.
In patients admitted for acute coronary syndrome (ACS), the guidelines of the European Society of Cardiology give a Class I, Level A recommendation for the prescription of high-intensity statins to be initiated as early as possible, regardless of the low-density lipoprotein cholesterol (LDL-C) level. Although statins are widely prescribed after ACS, the intensity of therapy and the proportion of patients achieving target LDL-C values are often not in line with recommendations due to a lack of compliance with guidelines by the physicians, a lack of compliance with treatment or poor tolerance by patients, and poor dose adaptation. In this context, a group of French physicians came together to define strategies to facilitate and improve the management of lipid-lowering therapy after ACS. This paper outlines the scientific rationale for the use of statins at the acute phase of ACS, the utility of ezetimibe, the measurement of LDL-C during the course of ACS, the opportunities for detecting familial hypercholesterolaemia and the results of the consensus for the management of lipid-lowering therapy, illustrated in two decision-making algorithms.
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Schiele et al. (2016) conducted a review in Acute coronary syndrome. Lipid-lowering therapy was evaluated. A consensus statement by French physicians provides decision-making algorithms to improve the management of lipid-lowering therapy, including statins and ezetimibe, after acute coronary syndrome.
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