Prevent the Event
Despite major advances in our understanding of atherosclerosis, ASCVD remains the leading cause of death globally.1
ASCVD has many different clinical manifestations, including acute events such as ACS, stroke and TIA, and chronic conditions such as PAD, CAD and cerebrovascular disease.2 Comorbidities such as T2DM alongside either PAD or CAD can further exacerbate a patient’s CV risk, but, according to ESC guidelines, all patients with ASCVD are at very high risk of a potentially fatal CV event.2
Whether it’s a first or recurrent CV event, both events can be devastating for patients and their loved ones. In addition to the physical burden, CV events impact mental health, quality of life, and can leave patients with long-term trauma.3
LDL-C levels represent the primary target for CV risk reduction, and should be controlled as part of a holistic approach that includes management of both lifestyle and modifiable risk factors.2
Explore this website to learn more about how you can reduce LDL-C levels and CV risk in your ASCVD patients, and help Prevent The Event.
How do you manage CV risk in your ASCVD patients?
Susan
Age 65, CAD+T2DM
Susan
Age 65, CAD+T2DM
Meet Susan, 65 years old
Diagnosed with T2DM at age 50
LDL-C: 2,8 mmol/L (108/dL)
BP: 130/80mmHG
HbA1c: 6.5%
BMI: 31 kg/m2
TGs: 1.9 mmol/L (165 mg/dL)
Complained of transient chest pain and dyspnoea when climbing stairs
Medications:
Lipid-lowering: rosuvastatin 40 mg, ezetimibe 10 mg
Antihypertensive: telmisartan 80 mg, amlodipine 10 mg
Glucose-lowering: insulin glargine 300 units/mL, metformin 2,000 mg, liraglutide 1.2 mg
Other: ASA 80 mg
| Did you know? Patients with combined T2DM and CAD have a 28% higher risk of CV events* compared to those without T2DM5 |
Eric
Age 63, CAD
Eric
Age 63, CAD
Meet Eric, 63 years old
Smoker
LDL-C: 2.9 mmol/L (112 mg/dL)
HbA1c: 5.0%
BP: 140/80 mmHg
TGs: 1.6 mmol/L (140 mg/dL)
BMI: 27 kg/m2
Complained of progressive persistent anginal symptoms 6 months ago; CTA was performed, 55% obstruction of left anterior descending artery was found. Subsequently, severe stenosis was confirmed during a cardiac cathererisation, and elective PCI was performed
Medications:
Lipid-lowering: rosuvastatin 40 mg, ezetimibe 10 mg Antiplatelet: clopidogrel 75 mg
Other: ASA 80 mg
| Did you know? Coronary artery disease (ischemic heart disease) is the leading cause of mortality worldwide6 |
John
Age 60, PAD+T2DM
John
Age 60, PAD+T2DM
Meet John, 60 years old
Smoker since the age of 20
Diagnosed with T2DM when he was 50
LDL-C: 2.5 mmol/L (98 mg/dL)
HbA1c: 7.1%
BMI: 27 kg/m2
TGs: 2.3 mmol/L (205 mg/dL)
Complains of moderate pain in calves on exertion, which is relieved by rest
Medications:
Lipid-lowering: atorvastatin 80 mg, ezetimibe 10 mg
Anticoagulant: rivaroxaban 5 mg
Glucose-lowering: insulin glargine 300 units/mL, metformin 2,000 mg, liraglutide 1.2 mg
Other: ASA 80 mg
| Did you know? Patients with combined T2DM and PAD have a nearly 8x higher risk of CV events compared with those without either condition7 |
Reducing CV risk in ACS patients
Gabby
Age 63, ACS patient
Meet Gabby, 63 years old
Smoking history: Smoker since the age of 25
Current medical event:
Diagnosis: First myocardial infarction (STEMI)
Current Status: Admitted to inpatient care
Clinical details:
Procedure: During cardiac catheterisation, a nearly complete obstruction of the LAD was found. The patient underwent a successful primary PCI
Vital statistics and laboratory results:
LDL-C: 4.5 mmol/L (174 mg/dL)
BMI: 26 kg/m2
HBA1c: 5.0%
BP: 120/70 mmHg
A holistic, multifactorial approach is paramount for reducing CV risk in ASCVD patients2
In addition to controlling LDL-C, dietary and other lifestyle changes are recommended to improve patients’ overall lipoprotein profile, including2:
- Smoking cessation
- Increased physical activity
- Weight reduction
Although LDL-C represents the primary target for reducing CV risk, reducing increased levels of causal CV risk factors such as BP and HbA1c should also be prioritised.2
What could uncontrolled LDL-C levels mean for your ASCVD patients?
Over 4 million deaths were attributed to elevated LDL-C in 2019. That's eight deaths per minute.4
Many LDL-C related CV events can be avoided with timely and optimised care. But with suboptimal lipid control, ASCVD patients face an immediate risk.2
Watch the video below to learn more about the potentially devastating impact of elevated LDL-C in patients with ASCVD.
ACS = acute coronary syndrome; ASCVD = atherosclerotic cardiovascular disease; BP = blood pressure; CAD = coronary artery disease; CV = cardiovascular; CVD = cardiovascular disease; ESC = European Society of Cardiology; HbA1c = glycated haemoglobin; HCP = healthcare professional; LDL-C = low-density lipoprotein cholesterol; PAD = peripheral artery disease; T2DM = type 2 diabetes mellitus; TIA = transient ischaemic stroke.
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Ray KK, Forence BA, Severin T, et al. World Heart Federation Cholesterol Roadmap 2022. Glob Heart. 2022; 17(1):75.
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Mach F, Baigent C, Catapano AL, et al. ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 2020;41(1):111-188.
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British Heart Foundation. Post traumatic stress disorder after a heart event. Available at: https://www.bhf.org.uk/informationsupport/support/emotional-support-and-wellbeing/post-traumatic-stress-disorder-after-a-heart-event. Last accessed: February 2025.
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Sheng J, Wang J, Zhang Y, et al. The Global Burden of Diseases attributed to high low-density lipoprotein cholesterol from 1990 to 2019. Front Public Health. 2022;10:891929.
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Mak K, Vidal-Petiot E, Young R, et al. Prevalence of diabetes and impact on cardiovascular events and mortality in patients with chronic coronary syndromes, across multiple geographical and ethnicities. European Journal of Preventive Cardiology. 2021;28:1795-1806.
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World Health Organization. The top 10 causes of death. 2020. https://www. w ho.int/news-room/fact-sheets/detail/the-top-10-causes-of-death. Accessed: February 2025.
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Saely CH, et al. Single and combined effects of peripheral artery disease and of type 2 diabetes mellitus on the risk of cardiovascular events: A prospective cohort study. Atherosclerosis. 2018;279:32-37.
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Ray KK, et al; SANTORINI Study Investigators. Treatment gaps in the implementation of LDL cholesterol control among high- and very high-risk patients in Europe between 2020 and 2021: the multinational observational SANTORINI study. Lancet Reg Health Eur. 2023 Apr 5;29:100624.
Relaterade Artiklar
Lipid management in patients with diabetes mellitus
Key principles of lipid management (LDL-C in particular) in accordance with the 2019 ESC/EAS Guidelines for the management of dyslipidaemias, and the 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes.
Acute LDL-C reduction post ACS: Strike early and strike strong: From evidence to clinical practice
A clinical consensus statement of Association for acute cardiovascular care (ACVC), in collaboration with European association of preventive cardiology (EAPC) and the European Society of Cardiology working group on cardiovascular Pharmacotherapy Krychtiuk KA, et al. Eur Heart J Acute Cardiovasc Care. 2022;11(12):939–949.
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