Introduction

Program Overview
Agenda
LDL-C and Atherosclerosis: A Coalescence
of Evidence
Main Principles for ASCVD Risk Reduction
Main Principles for ASCVD Risk Reduction
Main Principles for ASCVD Risk Reduction
Main Principles for ASCVD Risk Reduction
LDL-C Treatment Goals Are Based on an
Individual's CV Risk
Treatment Goal for LDL-C: 2019 ESC/EAS
Guidelines
Treatment Goal for LDL-C: 2019 ESC/EAS
Guidelines
Treatment Goal for LDL-C: 2019 ESC/EAS
Guidelines
Treatment Goal for LDL-C: 2019 ESC/EAS
Guidelines
Setting an LDL-C Goal
SCORE CV Risk Chart: 10-Year Risk of
Fatal CVD
Cumulative Effect of LDL-C Reduction
Use of LLT in Patients With Established
ASCVD
Data From the DA VINCI Study
LDL-C Goal Attainment in Patients With
Established ASCVD
Data From the DA VINCI Study
Central Role of LDL-C in ASCVD
Atherosclerosis Is CAUSED by Trapping
LDL-C (ApoB) Particles
Slowing Plaque Progression by Lowering
LDL-C
Slowing Plaque Progression by Lowering
LDL-C
Benefit of Lowering LDL-C Increases With
Each Additional Year of LDL-C Lowering
Clinical Benefit of Lowering LDL-C by
Magnitude and
Duration of Therapy
EAS Consensus Statement: LDL-C Causes
ASCVD
EAS Consensus Statement: LDL-C Causes
ASCVD
Goals of Lipid-Lowering Therapy
Lowering LDL-C by Lowering LDL Particles
Through the
LDL Receptor Pathway
Clinical Benefit of Any LLT Determined by
Absolute Reduction on ApoB-Containing
Particles
Clinical Benefit of Any LLT Determined by
Absolute Reduction on ApoB-Containing
Particles
Summary
Clinical Approach to the Management of
Dyslipidemia
As CVD Risk Increases, So Does Intensity of
Lipid-Lowering Therapy
Dyslipidemia Treatment
Clinical Approach to the Management of
Dyslipidemia
Choice of LLT
Know the Math: Intensity of Lipid-Lowering
Treatment
Principles of LDL-C Lowering
Stepwise Approach to Lowering LDL-C
2019 ESC/EAS Guidelines
Use Combination Lipid-Lowering Therapy as
First-Line Strategy in Very-High-Risk
Patients
Safety of Reduction of LDL-C to Very-Low
Levels (< 30 mg/dL)
Patient Example
Patient Example
Patient Example: Treatment Goal
Patient Example: Clinical Approach
Patient Example: Clinical Approach
Achievable Reductions of LDL-C as a
Function of the
Therapeutic Approach
Achievable Reductions of LDL-C as a
Function of the
Therapeutic Approach
Adherence to Long-Term Therapies
Success of Hyperlipidemia Treatment
Success of Hyperlipidemia Treatment
EUROASPIRE V Registry
CV Risk Factor Control in Patients With CAD
Medication Adherence in RCTs
Medication Adherence
Medication Adherence: Time for Success
Determinants of Medication Adherence
Using a Person-Centered Approach
Shared Decision-Making
Using a Person-Centered Approach
Shared Decision-Making
Shared Decision-Making
Multiple Benefits of Shared Decision-Making
for Patients
and Clinicians
Encourage Patients to Consider Certain
Questions Before
Their Appointment
Shared Decision-Making With Patients
Supporting Long-Term Change
Patient Decision Aids: Tips for
Communication
Patient Decision Aids: An Example
Peter K
Physical Examination
Laboratory Results
Peter K:
Multiple Recurrent CV Risk Factors
Peter K:
Multiple Recurrent CV Risk Factors
Swedish Heart Registry
Feasibility of Achieving LDL-C Targets:
HEYMANS Study
Very Potent LDL-C Reduction in Very-High-
Risk Patients:
Achieving Plaque Stabilization ( Regression)
Very Potent LDL-C Reduction in Very-High-
Risk Patient:
Data From the FOURIER-OLE
Peter K:
Multiple Recurrent CV Risk Factors
Peter K:
Multiple Recurrent CV Risk Factors
Lp(a) Elevation Markedly Increases ASCVD
Risk
Drug Therapy to Reduce Lp(a) Concentration
Peter K:
Multiple Recurrent CV Risk Factors
Despite Optimal Lipid-Lowering Therapy
Patients With Diabetes Are at Very High
ASCVD Risk
ASCVD Risk Reduction in Patients With
T2D
Peter K:
Multiple Recurrent CV Risk Factors
Medical Therapies Targeting Inflammation
Efficacy of Colchicine for CVD Risk
Reduction
Peter K:
Medication Changes to Reduce ASCVD Risk
A Real Challenge in Very-High-Risk Patients
Maria T
Maria T:
LDL-C Treatment Goal
Treatment Issues With This Patient
Proper Motivation Over the Long Term Is
Important
Maria T: Risk for ASCVD
Maria T: Years Gained Free of CV Events
Adherence to LLT Will Improve the Patient's
Outcome
Goals of Lipid-Lowering Therapy
Maria T: Clinical Approach
Maria T: Treatment Options
Maria T: Treatment Options
Initial Combination Therapy
Initial Combination Therapy