Page 5 - reflections_newsletter_June8_2022

REFLECTIONS dae mia
Dyslipidaemia Global Newsletter #2
aim ead
Dyslipi

The results showed that cumulative LDL-C during young adulthood and middle age were associated with the risk of incident CHDDys,lipi
independent of midlife LDL-C level. No association was found between LDL-C variables and ischaemic stroke or HF. These findings
suggest that past levels of LDL-C may inform strategies for
primary prevention of CHD and that maintaining optimal
LDL-C levels at an earlier age may reduce the lifetime risk of
developing atherosclerotic CVD.

CLINICAL PEARLS FROM THE FACULTY

WATCH The solid curve represents the adjusted HR for CHD associated with restricted
PROF. FARNIER’S THOUGHTS ON cubic splines for cumulative LDL-C. Shaded areas represent 95%CIs. The
THE RISK OF CARDIOVASCULAR
EVENTS IN YOUNG ADULTHOOD reference values (diamond dots) were set at 4000 mg/dL × years for cumulative
AND MIDDLE AGE LDL-C. Models were stratified by study cohort and adjusted for race and
CLICK HERE ethnicity, sex, birth year, body mass index, smoking status, high-density
FOR THE LINK TO FULL ARTICLE
lipoprotein cholesterol level, systolic blood pressure, diastolic blood pressure,
diabetes status, and use of lipid-lowering and antihypertensive medications.

Managing atherosclerotic cardiovascular risk in young adults: JACC state-of-the-
art review.

Stone NJ, et al. J Am Coll Cardiol. 2022 Mar 1;79(8):819-836.

This state-of-the-art review provides insights to help clinicians identify and address high-risk conditions in young adults (20-39 years),
reviews the current thinking on lipid risk factors such as triglycerides, non high-density lipoprotein cholesterol, apolipoprotein B, or
lipoprotein (a) in understanding an individual’s long-term ASCVD risk, and discusses the clinical utility of emerging strategies such as
coronary artery calcium (CAC) and polygenic risk scores in this age group.

Cholesterol levels measured early in life influence the development and progression of atherosclerosis and long-term ASCVD
risk. To reduce subsequent ASCVD in young adults aged 20-39 years, high-risk conditions can be identified and appropriately
intervened upon through lifestyle changes such as diet, activity, weight control, and smoking cessation. Measuring nonfasting lipids,
triglycerides, Lp(a), and apoB levels can identify high-risk patients.

In young adults with LDL-C =160 mg/dL, presence of a family history of premature ASCVD should lead to more intensive evaluation
and initiation of statin treatment. Statin therapy should also be considered for those with primary severe hypercholesterolaemia and
young adults with DM and DM risk factors.

Increased clinical attention and appropriate therapy to young adults at highest risk may prevent CV events in subsequent years.

TABLE OF CONTENTS Learn more at: www.serviercardiomedicalhub.com