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Experts' Introduction

Causal antiatherosclerotic therapy by LDL cholesterol lowering is effective to reduce myocardial infarction, ischemic stroke, and cardiovascular as well as all-cause mortality. Extremely low LDL cholesterol reduces ischemic strokes after ACS.

With the arrival of PCSK9 inhibitors, it has become possible to reduce blood LDL cholesterol to very low levels. The expectation of a further reduction of cardiovascular events over high intensity statin plus ezetimibe therapy has been met by two outcome trials, FOURIER and ODYSSEY OUTCOMES (OO).

Major cardiovascular events like myocardial infarction and cardiovascular mortality have been reduced. Accordingly, the new ESC/EAS guidelines in September 2019 have made recommendations now also involving PCSK9 inhibition.

Because recently further prespecified analyses have shown that even all-cause mortality can be reduced, this treatment has gained even more interest in the medical community.

Finally, days ago, from OO data it could be shown for the first time that - after ACS - LDL reduction is able to reduce the incidence of ischemic stroke by about one fourth without increasing hemorrhagic stroke.

This is a major breakthrough for LDL lowering to prevent strokes after ACS. We now have evidence that LDL cholesterol is a causal factor for atherosclerosis, that we can reduce atherosclerotic events by oral lipid-lowering drugs - particularly high-intensity statins and ezetimibe - and now by the subcutaneous application of antibodies to PCSK9.


Prof. Heinz Drexel,  FESC





Awad-Zied.jpgResources below have been selected by Dr. Awad Youssef Zeid

Young Member



ESC Clinical Practice Guidelines

guidelines-500.jpgA selection of relevant ESC Guidelines in the field

Acute Cardiovascular Care Congress Resources

ESC 365 visualA selection of resources from Acute Cardiovascular Care 2019

Statin use in octogenarians after a non-ST segment elevation acute coronary syndrome

Clinical Decision-Making Toolkit

ACCA-toolkit-2018-hands.jpgChapter 9 on Drugs in Acute Cardiovascular Care

Access the toolkit



ESC Guidelines on Dyslipidaemias 2016: new knowledge and tools for lipid management



European Heart Journal - Acute Cardiovascular Care

Journal-Acute-Cardiovascular-Care-EHJ.pngAccess a selection of relevant scientific papers in the field:

  1. Comprehensive efforts to increase adherence to statin therapy.
  2. New strategies for the development of lipid-lowering therapies to reduce cardiovascular risk.
  3. A commentary on the new ESC guidelines on dyslipidaemias
  4. Cost-effectiveness with PCSK9 inhibitors: a matter of costs
  5. Modelling the cost-effectiveness of PCSK9 inhibitors vs. ezetimibe through LDL-C reductions in a Norwegian setting