Prior to the current ESC/EAS Lipid Guideline, the previous guideline was published in August 2016 and so was not able to take into account the substantial body of recent published research demonstrating the association between ASCVD risk and the retention of low-density lipoproteins within the arterial wall. The 2019 ESC/EAS Lipid Guidelines are therefore an important resource to inform how to effectively and safely reduce CV (and ASCVD) risk through lipid modification.
In summary, the 2019 ESC/EAS Lipid Guidelines provide an update on a variety of trials assessing the efficacy and safety of combining statin therapy with novel treatments – such as PCKS9 inhibitors, ezetimibe and monoclonal antibodies – in reducing LDL-C levels. Importantly, the guideline proposes new goals for LDL-C levels, applying the latest evidence that shows there is no ‘lower limit’ for LDL-C reductions, and that the lower the achieved LDL-C values, the lower the risk of future CV events.
These guidelines are an important milestone in highlighting the causal role of low-density lipoproteins in ASCVD. They give an overview on the recent data around novel treatments for ASCVD, which traditional statin therapy does not significantly reduce risk of, and are especially relevant in the informing the treatment of high- and very-high-risk patients.