AACE, ACE Release Updated Dyslipidemia Clinical Practice Guidelines

The American Association of Clinical Endocrinologists (AACE) and the American College of Endocrinology (ACE) recently updated their clinical practice guidelines for dyslipidemia management and atherosclerosis prevention. The guidelines include a new cardiovascular risk category, along with new lipid management goals.

“This update expands considerably on our previous knowledge base and with newer clinical trial data addresses a broader range of disease stages with more intense treatment and more aggressive intervention,” Paul S Jellinger, MD, chair of the AACE Lipids Guidelines Update Task Force Writing Committee, said in a press release (American Association of Clinical Endocrinologists [press release] January 30, 2017).

First published in 2012 by AACE, the 2017 update of the Medical Guidelines for Clinical Practice for the Diagnosis and Treatment of Dyslipidemia and Prevention of Atherosclerosis introduces a cardiovascular disease “Extreme Risk” category and accompanying lipid-lowering treatment goals.

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According to the guideline update, the new Extreme Risk category focuses on patients who:

• have progressive cardiovascular disease;
• have unstable angina who have achieved a lowered LDL cholesterol level;
• have established cardiovascular disease accompanied by diabetes mellitus, chronic kidney disease (stage 3 or 4), or familiar hypercholesterolemia; and,
• are men 55 or younger and women 65 and younger who have a history of premature cardiovascular disease.

The guidelines emphasize the importance of assessing women for cardiovascular disease by using tools to determine the 10-year risk for a coronary event. Additional suggestions include diagnosing and managing children and adolescents with dyslipidemia as early as possible to decrease the long-term risk of adult cardiovascular events.

New additions to the 2017 guidelines include an assessment of the value of adding Zetia (ezetimibe; Merck) and PCSK9 inhibitors in treatment plans for patients with cardiovascular disease who are unable to reach LDL cholesterol goals with statin therapy.

“This statement will not only improve detection of the disease, but also provide the support necessary for physicians to ensure patients receive appropriate workup and optimal disease management to reduce further cardiovascular morbidity and mortality in these Extreme Risk patient groups,” Yehuda Handelsman, MD, chair of the AACE Lipids Guidelines Update Task Force, added in a press release.

—Julie Gould