SCIENTIFIC JOURNAL of the Hungarian Society of Cardiology

Expert recommendation for a more effective implementation of lipid lowering therapy pursuing the European and Hungarian guidelines in patients after acute coronary syndrome

█ Review

DOI: 10.26430/CHUNGARICA.2021.51.4.273

Márk László1, Harangi Mariann2, Paragh György2, Nagy Gergely György3, Kőszegi Zsolt4, Bednárszky Ildikó5, Járai Zoltán6,7, Csanádi Zoltán8
1Békés Megyei Központi Kórház, Pándy Kálmán Tagkórház, Kardiológia Osztály, Gyula
2Debreceni Egyetem Általános Orvostudományi Kar, Belgyógyászati Intézet, Anyagcsere Betegségek Nem Önálló Tanszék, Debrecen
3Borsod-Abaúj-Zemplén Megyei Központi Kórház, I. sz. Belgyógyászati Kardiológiai Osztály, Miskolc
4Szabolcs-Szatmár-Bereg Megyei Kórházak Jósa András Egyetemi Oktatókórház, Nyíregyháza
5Debreceni Egyetem Általános Orvostudományi Kar, Családorvos Tanszék, Oktató Praxis, Debrecen
6Szt. Imre Egyetemi Oktatókórház, Kardiológiai Profil, Budapest
7Semmelweis Egyetem, Általános Orvostudományi Kar, Városmajori Szív- és Érgyógyászati Klinika, Érsebészeti és Endovaszkuláris Tanszék, Angiológiai Tanszéki Csoport, Budapest
8Debreceni Egyetem Általános Orvostudományi Kar, Kardiológia Intézet, Debrecen


The most recent studies and meta-analyses proved that the lipid lowering therapy, the lowering of LDL-cholesterol level has become the key element of the primary and secondary cardiovascular prevention. There is no difference which drug is used, but LDL-cholesterol must be decreased to the lowest achievable level, as soon, as long and as low, as possible. Obviously, it is clear as well, that if the risk is higher, the available benefit is greater. At the same time we have to recognise that in lipid lowering treatment of patients after acute coronary syndrome there is still remaining room and urgent task for improvement.
The presidents and general secretaries of two medical associations, the Hungarian Society of Cardiology and the Hungarian Atherosclerosis Society, and the leaders of cardiology departments of four counties in the North-Eastern part of Hungary (Borsod-Abaúj-Zemplén, Szabolcs-Szatmár-Bereg, Hajdú-Bihar and Békés) and a cardiologist working as a general practitioner too, developed a common action plan to improve the lipid lowering treatment in patients after ACS. Its key elements are: 1.) detailed instructions for patients about next steps on hospital discharge report; 2.) increased involvement of general practitioners; 3.) exact timing and raising awareness of follow-up examinations; 4.) accurate planning of laboratory controls; 5.) the better patient education.
In order to improve long-term cardiovascular morbidity and mortality, it would be important for all colleagues who are is involved in the management of patients with acute coronary syndrome, such as discharging cardiologists, caregiver specialists and general practitioners to routinely apply recommendations listed in this article. In this practice trained nurses could be involved as well, in addition the optimalisation of lipid lowering treatment is a therapeutic area too, where the advantage of telemedicine should be applied.


click here to read the full article

click here to read the pdf