Therapieempfehlungen bei Fettstoffwechselstörungen: Die neue Leitlinie von 2019

Fettstoffwechselstörungen sind kausal für den Verlauf kardiovaskulärer Krankheiten. Durch frühe Diagnostik und zielwertorientierte Therapie lassen sich kardiovaskuläre Ereignisse reduzieren. Insofern kommt Hausärzten beim Screening und bei der Betreuung Betroffener eine Schlüsselrolle zu. Welche Empfehlungen die Leitlinie zu Risikostratifikation, Zielwertbestimmung und therapeutischen Strategien aufzeigt, erklärt dieser Beitrag.

Abstract

The updated guidelines for the management of dyslipidaemias 2019 sticks to the concept of individual risk-based intervention strategies, but intensifies LDL-C goals. Next to the established SCORE system non-invasive imaging techniques such as coronary CT or ultrasound of carotid or femoral arteries are now recommended for improved risk stratification. Screening for lipoprotein(a) identifies persons at higher cardiovascular risk. Non-statin trials with ezetimibe and PSCK9-inhibitors demonstrated further relative risk reduction for cardiovascular events. Cardiovascular risk reduction depends on the absolute lowering of LDL-C, duration of therapy and the individual cardiovascular risk. For patients at very high risk the new LDL-C goal is < 1.4 mmol/l (55 mg/dl) and reduction of ≥ 50 % from baseline. The overall aim is to reduce “cholesterol life years”.

Schlüsselwörter

Hypercholesterinämie - Fettstoffwechselstörungen - lipidsenkende Therapie - Prävention - kardiovaskuläre Krankheiten

Key words

hypercholesterolaemia - lipid disorders - lipid lowering therapy - prevention - cardiovascular disease

Publication History

Article published online:
19 January 2021

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