24th ASMIHA Coverage: A Joint Innovation for Lipid Management

PERKI 24th ASMIHA Coverage: A Joint Innovation for Lipid Management

JAKARTA --- The year 2013 marked the first guideline on the management of dyslipidemia to be launched by the Indonesian Heart Association (IHA). As one of its expert panels, Erwinanto, MD stated during his lecture in ESC-IHA joint symposium that in order to establish a highly relevant guideline to cope any management problems of dyslipidemia in Indonesia, the expert panels had adopted the 2011 ESC/EAS guideline which later on developed into 2013 ACC/AHA guideline. There had been discrepancies, however, between the two guidelines adopted. While ESC/EAS covered a broader parameter in terms of the scope and encompassment of data on covering dyslipidemia management, ACC/AHA had tried to emphasize on simplifying patient care.

Erwinanto, MD stressed that LDL-C targeted treatment should always be included in the guideline since it gives clinicians the idea of absolute risk and how should it be improved. Until this point dyslipidemia management has been aimed to reduce atherosclerotic cardiovascular disease (ASCVD) risk. LDL-C is the primary lipid analysis as the evidence showing that reducing LDL-C allows strong and compelling ASCVD prevention. The target of LDL-C treatments vary between different risk groups. Patients with very high risk patients such as those who have Cardiovascular Disease (CVD), the LDL-C target must be below 70 mg/dl. In high risk patients with SCORE ≥5% and <10% for 10-year risk of fatal CVD the target is below 100 mg/dl. Whereas LDL-C target below 115 mg/dl is aimed for people with moderate risk, whose SCORE is ≥1% and <5% at 10 years. There is strong evidence that reductions in major vascular events are directly proportional to the LDL reduction, with further benefit from more intensive statin therapy. Recipient of statin therapy benefit may be classified into four different groups, for each may receive high, moderate to low intensity statin therapy.

Corresponding to the guideline being discussed during the session, Prof.Diederick Grobbee from the European Society of Cardiology wants us to keep in mind that “neither the ESC/EAS nor the ACC/AHA guideline can be immediately translated to Indonesian. They give guidance indeed, however no definite rules have been established. Therefore it is not creating guidelines that is important, but to implement the advice proposed instead.”

By Media Aesculapius