Page 5 - Reflections_dyslipidaemia_newsletter4_2023

REFLECTIONS
Dyslipidaemia
Dyslipidaemia Global Newsletter #4 2023

successfully restarted on statins after trial completion. Therefore, the authors suggest a re-challenge with maximally tolerated statin in
combination with ezetimibe in parallel with initiating a PCSK9i. Dyslipidaemia

The authors emphasize the importance of a formulated lipid improvement plan at discharge and a clear referral pathway for early
follow-up and definite treatment. Patients should be re-evaluated four to six weeks after discharge, if possible, at the admission
hospital or another dedicated secondary prevention clinic caring for (high-risk) post-ACS patients.

Several barriers are discussed that may hinder reaching the LDL-C goal after an ACS, broadly classified as physician-, healthcare
system-, and patient-related. Physician barriers may include inadequate LLT prescription at discharge, lack of adherence to guideline
recommendations, and therapeutic inertia, while healthcare
system barriers may include cost and reimbursement issues, CLINICAL PEARLS FROM THE FACULTY
and poor coordination among healthcare stakeholders. Finally,
patient barriers may include poor adherence to treatment,
lack of educational opportunities during hospital admission,
increased statin intolerance awareness, and lack of trusted
educational sources on the internet along with misinformation.

With regards to improving medication adherence, the authors
suggest that physicians should promote patient education during
hospitalization and follow-up through effective communication
and provide educational material in different formats (e.g.,
booklets, educational videos, hospital and scientific societies’ WATCH
websites). In addition, they suggest that educational efforts PROF. SANDIN DISCUSS THE
targeted at physicians and providers caring for post-ACS RELEVANCE OF THE PROPOSED
patients focusing on evidence and guidelines and effective ALGORITHM IN PATIENTS POST-ACS.
strategies for increasing adherence are required.

While there may still be debate over LDL-C goals in patients after
ACS or characterized by more severe disease or recent events, CLICK HERE
the authors suggest that physicians should be fast and efficient in FOR THE LINK TO FULL ARTICLE
achieving currently formulated goals in this patient group.

Combination moderate-intensity statin and ezetimibe therapy for elderly patients

with atherosclerosis.
Lee SH, et al. J Am Coll Cardiol. 2023;81(14):1339-1349.

The Randomized Comparison of Efficacy and Safety of Lipid-lowering with Statin Monotherapy versus Statin/Ezetimibe Combination
for High-risk Cardiovascular Diseases (RACING) trial was a prospective, multicentre, randomized, open-label, non-inferiority clinical
trial including 3780 patients from 26 centres in South Korea which demonstrated that moderate-intensity statin with ezetimibe
combination therapy could achieve comparable efficacy with that of high-intensity statin monotherapy in terms of long-term composite
CV events and a lower rate of intolerance-related drug discontinuation or dose reduction.

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