Position of the Polish Cardiac Society on therapeutic targets for LDL cholesterol concentrations in secondary prevention of myocardial infarctions

• DOI: 10.33963/kp.a2023.0162
• Publication Date: 2023-09-03T21:00:50Z
• Authors: Przemysław Mitkowski; Adam Witkowski; Janina Stępińska; Maciej Banach; Piotr Jankowski; Mariusz Gąsior; Krystian Wita; Stanisław Bartuś; Paweł Burchardt; Michał M Farkowski; Marek Gierlotka; Robert Gil; Przemysław Leszek; Maciej Sterliński; Piotr Szymański; Mateusz Tajstra; Agnieszka Tycińska; Wojciech Wojakowski
• Keywords: Secondary Prevention; Position (finance)

Cardiovascular diseases account for 43% of deaths in Poland. The COVID-19 pandemic increased the number cardiovascular by as much 16.7%. Lipid metabolism disorders are observed about 20 million Poles. usually asymptomatic, they cause a significant increase risk diseases. Up to 20% patients who experience an acute coronary syndrome (ACS) may recurrence event within year, and up 40% these be re-hospitalized. Within 5 years after myocardial infarction, 18% suffer second ACS 13% have got stroke. Lipid-lowering therapy is extremely important element comprehensive management, both primary secondary prevention, its main goal prevent or extend time onset heart vascular disease reduce events. A patient with history belongs group very high due atherosclerosis. In this patients, low-density lipoprotein cholesterol levels should aimed below 55 mg/dl (1.4 mmol/l). Many scientific guidelines define extreme group, which includes not only two events years, but also additional clinical factors: peripheral disease, multivessel (multilevel atherosclerosis), familial hypercholesterolemia, diabetes at least one factor: elevated Lp(a) >50 hsCRP >3 mg/l, chronic kidney (eGFR <60 ml/min/1.73 m 2 ). LDL-C level 40 (1.0 Achieving therapeutic goals occur soon possible. For purpose, high-dose potent statin added diagnosis, ezetimibe if achieved 4–6 weeks. Combination considered selected from beginning. After weeks combination therapy, still achieved, adding proprotein convertase subtilisin/kexin type 9 protein inhibitor inclisiran considered. order compliance recommendations, Polish Cardiac Society propose attach patient's discharge letter statement clearly specifying what drugs used values achieved. It necessary cooperate between doctor, follow recommendations take medicines regularly, achieve maintain goals.