최신 콜레스테롤 치료 가이드라인: 2013 ACC/AHA Guideline and 2014 NICE Draft Guideline

Abstract

Low-density lipoprotein (LDL) cholesterol plays a major role in the development and progression of atherosclerosis. Numerous studies have demonstrated that the management of cholesterol, mainly treated with statins, can reduce LDL cholesterol levels and improve clinical outcomes. The American College of Cardiology (ACC) and American Heart Association (AHA) recently released new guidelines that included the new concept of atherosclerotic cardiovascular disease (ASCVD) and pooled cohort equations for estimation of the 10-year ASCVD risk in individuals. Conversely, the draft National Institute for Health and Care Excellence (NICE) guideline is currently being updated following its publication in 2008. This draft guidance introduced the QRISK2 risk assessment tool for the risk of development of cardiovascular disease in the next 10 years and combined with cost effectiveness. Importantly, both guidelines suggested moderate- to high-intensity statin therapy for the primary and secondary prevention of cardiovascular disease. In this article, we focus on the new risk assessments and recommendations for the use of lipid-lowering therapy in each guideline. (Korean J Med 2014;87:142-150) Keywords: Guideline; Cholesterol; Statins; HMG-CoA; Cardiovascular diseases