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2025

ESC/EAS 2025 Focused Update — Dyslipidaemias

2025 Focused Update of the 2019 ESC/EAS Guidelines for the management of dyslipidaemias

The focused update does not reopen the 2019 risk categories or LDL goals. It adds the agents and the refinements that arrived after them, which makes it a short document with a high density of examinable statements.

Three areas carry most of the questions. First, what to do when statins are genuinely not an option — bempedoic acid has a defined place here, and the question usually establishes intolerance properly before asking. Second, risk modifiers: family history, coronary calcium, lipoprotein(a) and how they are weighed alongside a calculated risk that sits near a treatment threshold rather than replacing it. Third, severe hypertriglyceridaemia and familial chylomicronaemia, where the therapeutic options are narrow and specific.

Read this one together with the 2019 guideline rather than instead of it. The goals and the stepwise escalation still live in the older text.

What is in the bank

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

Class of recommendation

Class I
7
Class IIa
10
Class IIb
0
Class III
0

Level of evidence

Level A
3
Level B
12
Level C
2

Sample questions

Dyslipidaemias (focused update) · 2025Class ILevel B
A 65-year-old woman with established atherosclerotic cardiovascular disease after an ischaemic stroke attends the lipid clinic. Four years ago simvastatin caused rhabdomyolysis, with a creatine kinase above ten thousand units per litre and acute kidney injury requiring hospital admission and intravenous fluids. Two years later a cautious rechallenge with rosuvastatin at the lowest available dose produced proximal myalgia with a rise in creatine kinase within three weeks and was stopped. Statin therapy is therefore not an option for her under any regimen. She has taken ezetimibe 10 mg daily for six months, tolerating it well, and her LDL cholesterol is 2.9 mmol/L, above her goal by a modest margin. Her renal function has recovered and is now normal. What should be added?
Pick the single best answer.
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