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Review
. 2024 May-Jun;18(3):e351-e373.
doi: 10.1016/j.jacl.2024.01.006. Epub 2024 Feb 8.

Lipid Association of India 2023 update on cardiovascular risk assessment and lipid management in Indian patients: Consensus statement IV

Raman Puri  1 , Manish Bansal  2 , Vimal Mehta  3 , P Barton Duell  4 , Nathan D Wong  5 , S S Iyengar  6 , Dinesh Kalra  7 , Devaki R Nair  8 , Navin C Nanda  9 , Jagat Narula  10 , P Deedwania  11 , Jamal Yusuf  12 , Jamshed J Dalal  13 , Sadanand Shetty  14 , Vinod M Vijan  15 , Rajeev Agarwala  16 , Soumitra Kumar  17 , Kris Vijay  18 , Aziz Khan  19 , Gurpreet Singh Wander  20 , P C Manoria  21 , S K Wangnoo  22 , Viswanathan Mohan  23 , Shashank R Joshi  24 , Balbir Singh  25 , Prafulla Kerkar  26 , Rajesh Rajput  27 , D Prabhakar  28 , Abdul Hamid Zargar  29 , Banshi Saboo  30 , Ravi R Kasliwal  31 , Saumitra Ray  32 , Sandeep Bansal  33 , M U Rabbani  34 , Shibba Takkar Chhabra  35 , Sarat Chandra  36 , Neil Bardoloi  37 , Narasaraju Kavalipati  38 , Immaneni Sathyamurthy  39 , Kunal Mahajan  40 , Akshya Pradhan  41 , N N Khanna  42 , Rajesh Khadgawat  43 , Preeti Gupta  44 , Milan C Chag  45 , Ashu Gupta  46 , A Murugnathan  47 , S N Narasingan  48 , Sundeep Upadhyaya  49 , Vinod Mittal  50 , Rashida Patanwala Melinkeri  51 , Madhur Yadav  52 , M Raseed Mubarak  53 , K K Pareek  54 , Pradeep Kumar Dabla  55 , Rashmi Nanda  56 , J C Mohan  57
Affiliations
Free article
Review

Lipid Association of India 2023 update on cardiovascular risk assessment and lipid management in Indian patients: Consensus statement IV

Raman Puri et al. J Clin Lipidol. 2024 May-Jun.
Free article

Abstract

Objective: In 2016, the Lipid Association of India (LAI) developed a cardiovascular risk assessment algorithm and defined low-density lipoprotein cholesterol (LDL-C) goals for prevention of atherosclerotic cardiovascular disease (ASCVD) in Indians. The recent refinements in the role of various risk factors and subclinical atherosclerosis in prediction of ASCVD risk necessitated updating the risk algorithm and treatment goals.

Methods: The LAI core committee held twenty-one meetings and webinars from June 2022 to July 2023 with experts across India and critically reviewed the latest evidence regarding the strategies for ASCVD risk prediction and the benefits and modalities for intensive lipid lowering. Based on the expert consensus and extensive review of published data, consensus statement IV was commissioned.

Results: The young age of onset and a more aggressive nature of ASCVD in Indians necessitates emphasis on lifetime ASCVD risk instead of the conventional 10-year risk. It also demands early institution of aggressive preventive measures to protect the young population prior to development of ASCVD events. Wide availability and low cost of statins in India enable implementation of effective LDL-C-lowering therapy in individuals at high risk of ASCVD. Subjects with any evidence of subclinical atherosclerosis are likely to benefit the most from early aggressive interventions.

Conclusions: This document presents the updated risk stratification and treatment algorithm and describes the rationale for each modification. The intent of these updated recommendations is to modernize management of dyslipidemia in Indian patients with the goal of reducing the epidemic of ASCVD among Indians in Asia and worldwide.

Keywords: Atherosclerotic cardiovascular disease; Carotid plaque; Coronary calcium score; Expert consensus; Femoral plaque; Guidelines; High-intensity statin therapy; Metabolic syndrome; Non-conventional risk factors.

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Conflict of interest statement

Declaration of competing interest Raman Puri: Boehringer Ingelheim, Novartis Manish Bansal: Sun Pharmaceuticals, USV, Dr Reddy's Labs, Cipla, Eris Lifesciences, Intas Pharmaceuticals, AstraZeneca Pharma India, Novartis Vimal Mehta: Institutional research grants from Amgen, Boehringer Ingelheim, Novo Nordisk, Eli Lilly, LIB Therapeutics, AstraZeneca, Torrent P Barton Duell: Advisory activities: Akcea/Ionis, Esperion, Regeneron, Kaneka, Novo Nordisk. Institutional grants: Regeneron, Regenxbio, Retrophin/Travere Nathan Wong: Research support through UC Irvine: Regeneron, Novo Nordisk, Novartis, Eli Lilly, Consultant: Novartis, Ionis, Agepha SS Iyengar: Reddy's Lab, Amgen, Emcure, Glenmark, Boehringer Ingelheim, Pfizer, Novartis Devaki Nair: Novartis, Daichi Sankyo Krishnaswami Vijayaraghavan: Amgen, AstraZeneca, Boehringer Ingelheim, Esperion, Novo Nordisk, Pfizer V Mohan: Servier, MSD, Novo Nordisk, Novartis, Eli Lilly, USV, Lifescan J & J, Sanofi Aventis, Merck, Boehringer Ingelheim, Abbott, Several Indian Pharmaceutical companies Shashank Joshi: Biocon, Cadilla, Twin Health, Glenmark, Torrent, Marico, MSD, Novo Nordisk, Sanofi, Boehringer Ingelheim, Abbott, AstraZeneca, USV, Alkem, Serdia Saumitra Ray: Merck, Novartis, Boehringer Ingelheim, Astra Zeneca, Novartis Sandeep Bansal: Novo Nordisk, Vascular Innovations Co. Ltd, Bayer, Portico India, ICMR SN Narasingan: IPCA, Novartis, USV, Torrent, SUN Pharma J C Mohan: Novartis, Lupin, Sun pharmaceuticals, Astra Zeneca, Intas, Le Servier, Sanofi Other authors report no conflict of interest.

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