SCIENTIFIC JOURNAL of the Hungarian Society of Cardiology

Possibilities of guideline directed lipid-lowering treatment in patients after a cardiovascular event in Hungary in 2023–2024 – the priority of the fix dose combination

█ Review

DOI: 10.26430/CHUNGARICA.2023.53.5.491

Márk László1, Nagy Mária2, Papp Viola1
1Békés Vármegyei Központi Kórház, Pándy Kálmán Tagkórháza, Kardiológia Osztály, Gyula
2Békés Vármegyei Központi Kórház, Pándy Kálmán Tagkórháza, Kardiológiai Rehabilitációs Osztály, Gyula


It is a basic principle of lipidology that the higher the cardiovascular risk, the greater the benefit. This explains why the guideline directed treatment of patients with acute coronary syndrome (ACS) is of great importance. Despite this, Hungarian studies, as well as the multinational DaVinci and SANTORINI studies, confirmed that only around 20% of the patients reached the target value of 1.4 mmol/l LDL-cholesterol (LDL-C). Would that be the maximum achievable with daily practice? Obviously not. According to the Swedish myocardial infarction registry, the SWEDEHEART results, during the second follow-up visit after ACS, the achievement of the target value of 1.4 mmol/l was 41% in 2020, 52% in 2021, and 56% in 2022. In addition to the administration of high-intensity statins, the fact that the administration of ezetimibe has become more and more frequent over the years, exceeding 50% in 2022, may have the biggest role in this. The importance of the use of ezetimibe is also supported by recent clinical studies, as well as a new expert opinion, according to which the statin and ezetimibe combination should be started as a first line treatment as soon as a very high risk is established. The fix dose combination administration of statin and ezetimibe improves adherence by 87% compared to administration of two tablets. In the case of better adherence fewer cardiovascular events are expected.


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