The event is not a coincidence, or the need for long-term and effective cardiovascular risk control
Authors:
Martin Šatný; Michal Vrablík
Authors‘ workplace:
Centrum preventivní kardiologie, III. interní klinika – endokrinologie a metabolismu 1. LF UK a VFN v Praze
Published in:
AtheroRev 2025; 10(3): 161-166
Category:
Reviews
Overview
Atherosclerotic cardiovascular diseases (ASCVD) are still the leading cause of morbidity and mortality not only in the Czech Republic but also globally. A crucial role in this regard is played by long-term exposure to elevated LDL-cholesterol (LDL-C) levels, which according to current knowledge is generally considered to be the only causal risk factor for atherothrombotic complications. Thus, it is not rational to consider primary or secondary prevention of ASCVD, but rather early and vigorous intervention of cardiovascular (CV) risk or partial CV risk factors, especially LDL-C. The starting point of our therapeutic approach is always the determination of the CV risk of a given patient, from which the target LDL-C or other lipid parameters are then set. The use of CV risk modifiers such as lipoprotein(a) or assessment of preclinical atherosclerosis by imaging methods (carotid duplex sonography or coronary calcium score) is also advantageous. The cornerstone of treatment is always dietary and regimen measures, followed by adequate pharmacological intervention in indicated cases, with a current emphasis on early combination lipid-lowering therapy.
Keywords:
statin – cardiovascular risk – ezetimibe – LDL-cholesterol – PCSK9 inhibitors – atherosclerotic cardiovascular disease
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