Lipid-Management 2020 – medikamentöse Therapie und Lipidapherese im Kontext

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Medikamentöse Therapie Die aktualisierte Dyslipidämie-Leitlinie der European Society of Cardiology senkt nochmals die LDL-Cholesterinzielwerte. Zur Erreichung dieser Zielwerte werden hochpotente Statine und vermehrt Kombinationspartner wie Ezetimib und PCSK9-Hemmer nötig werden.

Lipidapherese Die Bestimmung von Lipoprotein(a) zur kardiovaskulären Risikostratifizierung ist nun eine Klasse-II(a)-Empfehlung. Momentan steht lediglich die Lipidapherese zur Senkung von Lipoprotein(a) zur Verfügung, neue medikamentöse Therapieansätze sind allerdings in der klinischen Erprobung.

Abstract

The recently updated 2019 European Society of Cardiology/European Atherosclerosis Society Guidelines for the management of dyslipidaemias set new, ambitious goals for lipid lowering based on recently generated evidence from large outcome trials. Noninvasive imaging as well as measurement of lipoprotein(a) as a non-traditional risk factor is advocated for the refinement of risk stratification. A highly potent statin – defined as a drug that lowers LDL-cholesterol by 50 % from baseline – is recommended as the standard choice of treatment, whenever medical lipid lowering is indicated. Combining different therapeutic strategies such as a statin with ezetimibe and/or a Proproteinkonvertase Subtilisin Kexin Type 9 inhibitor allows to achieve the new treatment targets. If needed, lipid apheresis can complement the medical armamentarium. Moreover, lipid apheresis remains the only approved treatment modality for lowering lipoprotein(a), however medical treatments are under current investigation.

Schlüsselwörter

Lipoprotein(a) - Lipidapherese - PCSK9

Key words

lipoprotein(a) - lipid apheresis - PCSK9

Publikationsverlauf

Artikel online veröffentlicht:
01. April 2020

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