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<p>The 2025 focused update of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) guidelines on the management of dyslipidemia introduces new recommendations for cardiovascular risk classification based on SCORE2 and SCORE2-OP. In addition to traditional risk factors, risk modifiers are recommended as supplementary decision aids in risk stratification. The low-density lipoprotein-cholesterol (LDL-C) target levels established in 2019 remain unchanged in the 2025 update. A&#xa0;novelty is the recommendation of bempedoic acid as an additional pharmacological option for lowering LDL‑C. The combination of statins, ezetimibe, PCSK9 monoclonal antibodies and bempedoic acid enables more intensive LDL‑C reduction according to individual needs. New evidence in the setting of acute coronary syndrome (ACS) is summarized by the principles “the sooner, the lower, the better” and “strike early and strong”. To implement these clinically important concepts, early use of lipid-lowering combination therapy is recommended. In most patients with ACS treatment should be initiated immediately with a&#xa0;combination of atorvastatin or rosuvastatin plus ezetimibe. Patients with ACS who are already receiving lipid-lowering therapy benefit from further intensification. The ESC and EAS emphasize the importance of lipoprotein(a) as a&#xa0;cardiovascular risk factor and recommend its measurement at least once in a&#xa0;lifetime. New recommendations also support statin therapy in individuals with HIV infections or in patients with cancer who have a high risk of chemotherapy-related cardiotoxicity. In contrast, the use of dietary supplements or vitamins for lipid lowering and cardiovascular risk reduction is discouraged.</p>

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Management von Fettstoffwechselstörungen – DGK-Kommentar zu den Leitlinien der ESC/EAS (2025)

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年2月18日

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  • Ulrich Laufs,
  • Oliver Husser,
  • Ulf Landmesser,
  • Peter Lüdike,
  • Winfried März,
  • Stephan Henrik Schirmer,
  • Sven Wassmann,
  • Oliver Weingärtner

摘要

The 2025 focused update of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) guidelines on the management of dyslipidemia introduces new recommendations for cardiovascular risk classification based on SCORE2 and SCORE2-OP. In addition to traditional risk factors, risk modifiers are recommended as supplementary decision aids in risk stratification. The low-density lipoprotein-cholesterol (LDL-C) target levels established in 2019 remain unchanged in the 2025 update. A novelty is the recommendation of bempedoic acid as an additional pharmacological option for lowering LDL‑C. The combination of statins, ezetimibe, PCSK9 monoclonal antibodies and bempedoic acid enables more intensive LDL‑C reduction according to individual needs. New evidence in the setting of acute coronary syndrome (ACS) is summarized by the principles “the sooner, the lower, the better” and “strike early and strong”. To implement these clinically important concepts, early use of lipid-lowering combination therapy is recommended. In most patients with ACS treatment should be initiated immediately with a combination of atorvastatin or rosuvastatin plus ezetimibe. Patients with ACS who are already receiving lipid-lowering therapy benefit from further intensification. The ESC and EAS emphasize the importance of lipoprotein(a) as a cardiovascular risk factor and recommend its measurement at least once in a lifetime. New recommendations also support statin therapy in individuals with HIV infections or in patients with cancer who have a high risk of chemotherapy-related cardiotoxicity. In contrast, the use of dietary supplements or vitamins for lipid lowering and cardiovascular risk reduction is discouraged.