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CardioLogIQ
2019

ESC/EAS 2019 Guidelines — Dyslipidaemias

2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk

The 2019 guideline still carries the risk categories and the LDL cholesterol goals, and the 2025 focused update leaves them in place. Knowing which category a patient falls into, and the two-part goal that follows — a percentage reduction from baseline and an absolute value — is the foundation most questions build on.

Risk assessment has its own rules that are easy to get wrong. General population charts do not apply to diabetes or to familial hypercholesterolaemia; those patients are graded by the condition.

Treatment is a stepwise escalation: statin to maximally tolerated dose, then ezetimibe, then a PCSK9 inhibitor, with defined criteria at each step. Special populations carry firm statements worth memorising — pregnancy and the planning of it, heart failure without another indication, severe renal impairment — and they are tested more often than their prevalence would suggest.

What is in the bank

90 active questions. Class and level follow the recommendation each question is built from.

Class of recommendation

Class I
55
Class IIa
17
Class IIb
10
Class III
8

Level of evidence

Level A
28
Level B
15
Level C
47

Sample questions

Dyslipidaemias · 2019Class IIILevel C
A 58-year-old woman with type 2 diabetes diagnosed seven years ago attends for review. Her blood pressure is 138/82 mmHg on ramipril, her HbA1c is 7.1% on metformin, her LDL cholesterol is 3.5 mmol/L and she has never smoked. She has no known atherosclerotic disease, no albuminuria, no retinopathy and no neuropathy, and her estimated glomerular filtration rate is 84 mL/min/1.73 m². She takes no lipid-lowering drug. The registrar proposes entering her age, sex, blood pressure, smoking status and cholesterol into the general population risk chart in order to decide whether she needs a statin. How should her cardiovascular risk be established?
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