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Målvärden för LDL-kolesterol har satts ur spel. Kolesterolet bör sänkas maximalt vid hög kardiovaskulär risk: [Target levels for LDL cholesterol are put out of the running. Cholesterol should be lowered maximally in high cardiovascular risk]
Linköping University, Department of Medical and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Endocrinology and Gastroenterology UHL.
2011 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 108, no 22-23, 1240-1243 p.Article in journal (Other academic) Published
Abstract [sv]

En utökad metaanalys från Cholesterol Treatment Trialists’ (CTT) Collaboration har inkluderat fem studier av lågdos vs högdos statin med totalt 170 000 deltagare.

Här visades att ytterligare 1 mmol/l sänkning av LDL-kolesterol på ett säkert sätt minskar risken för stora kar­dio­vaskulära händelser med 22 procent, oavsett ini­tialt LDL-kolesterolvärde.

Patienter med hög risk för kardiovaskulära händelser har nytta av intensiv statinbehandling även om LDL-kolesterolvärdet är <2 mmol/l.

IDEAL-studien pekar på sjukdomsvinster med statinbehandling som ger LDL-kole­sterol <2,0 mmol/l.

En översyn av målvärdet för LDL-kolesterol i sekundär prevention bör göras. Dessutom ska alla högriskpatienter som redan har <2 mmol/l LDL-kolesterol statinbehandlas.

Simvastatin i dosen 80 mg dagligen bör dock undvikas på grund av risk för muskelbiverkningar.

Abstract [en]

In an expanded meta analysis from the Cholesterol Treatment Trialists (CTT) Collaboration, incorporating additional five trials of more versus less statin therapy, was demonstrated that one additional mmol/L LDL cholesterol reduction safely decreases the risk of major vascular events, regardless of initial LDL cholesterol level by about one fifth. The CTT authors suggest that patients with high risk of cardiovascular events would benefit from intensive statin therapy even if baseline LDL cholesterol is below 2 mmol/L. The Scandinavian IDEAL trial also indicates that health benefits could be obtained with statin therapies resulting in LDL cholesterol below 2,0 mmol/L compared with study participants not reaching this level. The author suggests a reconsideration of the goal for LDL cholesterol in secondary prevention in Sweden and that all high-risk patients with an initial LDL cholesterol under 2.0 mmol/L also should be treated with statins.

Place, publisher, year, edition, pages
Läkartidningen Förlag , 2011. Vol. 108, no 22-23, 1240-1243 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-76056OAI: oai:DiVA.org:liu-76056DiVA: diva2:511940
Available from: 2012-03-24 Created: 2012-03-24 Last updated: 2017-12-07

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Olsson, Anders G.

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