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Review
. 2024 Feb 17:55:74-92.
doi: 10.1016/j.athplu.2024.01.004. eCollection 2024 Mar.

Executive summary of the Hellenic Atherosclerosis Society guidelines for the diagnosis and treatment of dyslipidemias - 2023

N Katsiki  1   2 , Td Filippatos  3 , C Vlachopoulos  4 , D Panagiotakos  5 , H Milionis  6 , A Tselepis  7 , A Garoufi  8 , L Rallidis  9 , D Richter  10 , T Nomikos  5 , G Kolovou  11 , K Kypreos  2   12 , C Chrysohoou  13 , K Tziomalos  14 , I Skoumas  15 , I Koutagiar  16 , A Attilakos  17 , M Papagianni  18 , C Boutari  19 , V Kotsis  20 , C Pitsavos  21 , M Elisaf  22 , K Tsioufis  23 , E Liberopoulos  24
Affiliations
Review

Executive summary of the Hellenic Atherosclerosis Society guidelines for the diagnosis and treatment of dyslipidemias - 2023

N Katsiki et al. Atheroscler Plus. .

Abstract

Atherosclerotic cardiovascular disease (ASCVD) remains the main cause of death worldwide, and thus its prevention, early diagnosis and treatment is of paramount importance. Dyslipidemia represents a major ASCVD risk factor that should be adequately managed at different clinical settings. 2023 guidelines of the Hellenic Atherosclerosis Society focus on the assessment of ASCVD risk, laboratory evaluation of dyslipidemias, new and emerging lipid-lowering drugs, as well as diagnosis and treatment of lipid disorders in women, the elderly and in patients with familial hypercholesterolemia, acute coronary syndromes, heart failure, stroke, chronic kidney disease, diabetes, autoimmune diseases, and non-alcoholic fatty liver disease. Statin intolerance is also discussed.

Keywords: Atherosclerotic cardiovascular disease; Bempedoic acid; Ezetimibe; Familial hypercholesterolemia; Heart failure; PCSK9 inhibitor; Statins; Type 2 diabetes.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
HellenicSCORE II – 10-year risk of fatal ASCVD in Greece. (Reproduced with permission from Panagiotakos et al. [5]). ASCVD: atherosclerotic cardiovascular disease.
Fig. 2a
Fig. 2a
Management of dyslipidemia in statin-naïve patients with acute coronary syndromes (ACS). STEMI: ST-elevation myocardial infarction; NSTEMI: non-ST-elevation myocardial infarction; UA: unstable angina; LDL-C: low-density lipoprotein cholesterol; PCSK9: proprotein convertase subtilisin/kexin type 9.
Fig. 2b
Fig. 2b
Management of dyslipidemia in statin-treated patients with acute coronary syndromes (ACS). STEMI: ST-elevation myocardial infarction; NSTEMI: non-ST-elevation myocardial infarction; UA: unstable angina; LDL-C: low-density lipoprotein cholesterol.
Fig. 2c
Fig. 2c
Management of dyslipidemia in statin-plus-ezetimibe-treated patients with acute coronary syndrome (ACS). STEMI: ST-elevation myocardial infarction; NSTEMI: non-ST-elevation myocardial infarction; UA: unstable angina; LDL-C: low-density lipoprotein cholesterol; PCSK9: proprotein convertase subtilisin/kexin type 9.
Fig. 3
Fig. 3
Algorithm for the management of patients with statin-associated muscle symptoms. CK: creatine kinase; ULN: upper limit of normal; TSH: thyroid-stimulating hormone; LDL-C: low-density lipoprotein cholesterol; CVD: cardiovascular disease; PCSK9: proprotein convertase subtilisin/kexin type 9.
Fig. 4
Fig. 4
ASCVD risk groups and LDL-C targets. ASCVD: atherosclerotic cardiovascular disease; LDL-C: low-density lipoprotein cholesterol; CKD: chronic kidney disease; FH: familial hypercholesterolemia.
Fig. 5
Fig. 5
Proposed treatment algorithm for the management of patients with dyslipidemia - 2023. ASCVD: atherosclerotic cardiovascular disease; LDL-C: low-density lipoprotein cholesterol; CKD: chronic kidney disease; FH: familial hypercholesterolemia.
Fig. 6
Fig. 6
Eligible patients for PCSK9 inhibitor initiation. PCSK9: proprotein convertase subtilisin/kexin type 9; ASCVD: atherosclerotic cardiovascular disease; LDL-C: low-density lipoprotein cholesterol; CKD: chronic kidney disease; FH: familial hypercholesterolemia.
Fig. 7
Fig. 7
Laboratory follow-up in patients on hypolipidemic drug treatment.
Fig. 8
Fig. 8
Proposed reporting of lipid test results in adults.
See this image and copyright information in PMC

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