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최신 콜레스테롤 치료 가이드라인: 2013 ACC/AHA Guideline and 2014 NICE Draft Guideline

Recent Guidelines on the Management of Blood Cholesterol: 2013 ACC/AHA Guidelines and 2014 NICE Draft Guidelines

  • 허승호 (계명대학교 의과대학 계명대학교 동산의료원 심장내과)
  • Hur, Seung-Ho (Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Hospital, Keimyung University School of Medicine)
  • 발행 : 2014.08.01

초록

Low-density lipoprotein (LDL) cholesterol plays a major role in the development and progression of atherosclerosis. Numerous studies have demonstrated that the management of cholesterol, mainly treated with statins, can reduce LDL cholesterol levels and improve clinical outcomes. The American College of Cardiology (ACC) and American Heart Association (AHA) recently released new guidelines that included the new concept of atherosclerotic cardiovascular disease (ASCVD) and pooled cohort equations for estimation of the 10-year ASCVD risk in individuals. Conversely, the draft National Institute for Health and Care Excellence (NICE) guideline is currently being updated following its publication in 2008. This draft guidance introduced the QRISK2 risk assessment tool for the risk of development of cardiovascular disease in the next 10 years and combined with cost effectiveness. Importantly, both guidelines suggested moderate- to high-intensity statin therapy for the primary and secondary prevention of cardiovascular disease. In this article, we focus on the new risk assessments and recommendations for the use of lipid-lowering therapy in each guideline.

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참고문헌

  1. Stone NJ, Robinson J, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. Circulation 2014;129(25 Suppl 2):S1-45. https://doi.org/10.1161/01.cir.0000437738.63853.7a
  2. National Institute for Health and Care Excellence. Lipid modification (update): draft full guideline. England: National Institute for Health and Care Excellence, 2014. Available from: http://www.nice.org.uk/Guidance/InDevelopment/GID-CGWAVER123/Documents
  3. Mihaylova B, Emberson J, Blackwell L, et al. The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials. Lancet 2012;380:581‐590. https://doi.org/10.1016/S0140-6736(12)60367-5
  4. Taylor F, Huffman MD, Macedo AF, et al. Statins for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev 2013;1:CD004816.
  5. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002;106:3143-3421.
  6. Boden WE, Probstfield JL, Anderson T, et al. Niacin in patients with low HDL cholesterol levels receiving intensive statin therapy. N Engl J Med 2011;365:2255-2267. https://doi.org/10.1056/NEJMoa1107579
  7. National Institute for Health and Care Excellence. 2014 NICE LIPID modification draft for consultation. England: National Institute for Health and Care Excellence, 2014. Available from: http://www.nice.org.uk/Guidance/InDevelopment/GID-CGWAVER123/Documents

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