LDL-C target for cardiovascular dz will be lowered in Korea

The Korean Society of Lipid and Atherosclerosis Reveals Amendment to Guidelines for Treatment of Dyslipidemia

Break down into 5 existing groups of 4

The LDL-C target figure for South Korea's ultra-high-risk group for cardiovascular diseases is expected to be lowered to a similar level to global guidelines.

 

The Korean Society of Lipid and Atherosclerosis held the Spring Cardiovascular Integration Academic Conference online and offline at the HICO on the 15th and 16th and unveiled some of the latest revised versions of the Dyslipidemia Treatment Guidelines.

 

This amendment (the 5th edition) is the first revision of the guidelines for treating dyslipidemia in 4 years since 2018.

 

In the meantime, in the United States and Europe, LDL-C targets for ultra-high-risk groups for cardiovascular diseases were lowered simultaneously.

 

The ESC recommended lowering the target LDL-C level of the ultra-high-risk group for cardiovascular disease to 55 mg/dL, and considering less than 40 for extreme risk groups, such as patients who have experienced a second cardiovascular event.

 

The AACE also recommends the LDL-C target value of the extreme risk group for cardiovascular disease at 55.

 

This is because the premise that "the lower the LDL-C level, the higher the cardiovascular disease-related benefits" is accepted internationally.

 

Korea, which remained in the 2018 guidelines, still sets the LDL-C target value for the ultra-high-risk group below 70.

 

As the revision was made for the first time in four years, Korea also included changes in global guidelines in the new revision.

 

The main focus of the amendment is a stronger LDL-C treatment strategy than before.

 

Kim Sang-hyun, a professor of circulatory internal medicine at Seoul National University Hospital, introduced the framework and direction of the revision being prepared this year under the theme of "the goal of LDL-C treatment for ultra-high-risk/high-risk groups for cardiovascular diseases." According to the revised bill released by Professor Kim, the society classified the clinical situation into five according to the patient's risk level by judging the presence or absence of cardiovascular risk factors, and recommended lowering the LDL-C target overall by risk group.

 

If the existing guidelines consisted of four groups: ultra-high-risk, high-risk, medium-risk, and low-risk, the revision is characterized by more detailed groups.

 

Among the five groups according to the clinical situation, the highest risk group is coronary artery disease and diabetes (with targeted organ damage or three or more major cardiovascular disease risk factors).

 

The amendment presented the group with the lowest LDL-C target of less than 55.

 

The second group is a case of atherosclerosis ischemic stroke/daily cerebral ischemic stroke, carotid artery disease, peripheral artery disease, abdominal aneurysm, diabetes (with risk factors for cardiovascular disease over 10 years of illness or one or two).

 

It was recommended that the group be targeted below LDL-C 70.

 

The third group is a group of patients with less than 10 years of diabetes and no major risk factors for cardiovascular disease, with a target figure of less than 100.

 

The other two groups were moderate risk groups (more than two major risk factors) and low risk groups (less than one major risk factor), respectively, with LDL-C targets of less than 130 and 160.

 

It is noteworthy that LDL-C target values of coronary artery disease patients who have experienced myocardial infarction and angina were adjusted to be less than 55 and at least 50% lower than the baseline (Recommended grade 1, Evidence level A).

 

Existing medical guidelines recommended reducing the LDL-C target for these patients by less than 70 or 50% or more.

 

The association plans to unveil the final revision within the first half of this year.

 

It is because it is still judged that expert discussion is necessary.

 

In the case of diabetic patients, it was agreed that more discussion is needed on what to do with the LDL-C target value depending on the risk.

 

A domestic data base to be used in determining patient risk should also be established.