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REFLECTIONS
Dyslipidaemia
Dyslipidaemia Global Newsletter #6 2023

The authors noted that the effects of overweight and obesity may be mediated by hyperlipidaemia, hypertension, and diabetes. In
addition, the definition of current smoking may not capture the spectrum and dose of tobacco exposure, and smoking cessation Dyslipidaemia
during follow-up might have led to an underestimation of smoking as a risk factor.

Given that more than half the cases of incident CVD and one-
fifth of deaths in adults may be attributable to these modifiable
risk factors, better management of these conditions may improve
patient outcomes.

WATCH
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ARTICLE HERE (2:12 MINS) FOR THE LINK TO FULL ARTICLE

CLINICAL GUIDELINES/STATEMENTS

2023 ESC Guidelines for the management of acute coronary syndromes.
Byrne RA, et al. Eur Heart J. 2023 Oct 12;44(38):3720-3826.

The new ESC guidelines for the management of acute coronary Think invasive management: Based on the initial assessment,
syndrome encompasses the full spectrum of the syndrome, the healthcare provider can decide whether immediate invasive
including unstable angina, ST-elevation myocardial infarction management is required. Patients with STEMI require primary
(STEMI) and non-ST-elevation myocardial infarction (NSTEMI). percutaneous coronary intervention (PPCI) (or fibrinolysis
In the new guidelines, the concept of a working diagnosis to final if PPCI within 120 min is not feasible); patients with non-
diagnosis is introduced to ensure a comprehensive evaluation ST-elevation ACS (NSTE-ACS) with very high-risk features
and management of patients with ACS from symptom onset require immediate angiography ± PCI if indicated; patients with
through to management and follow-up. NSTE-ACS and high-risk features should undergo inpatient
angiography (angiography within 24 h should be considered).
The guidelines provide a framework of considerations or
key topics to ‘think about’ for the timely assessment and Think antithrombotic therapy: A combination of antiplatelet
management of patients with ACS. and anticoagulant therapy is indicated acutely for patients with
ACS.
Think A.C.S. at initial assessment: If ACS is suspected,
think ‘A.C.S.’ for the initial triage and assessment. This Think revascularization: The majority of patients with ACS will
involves performing an electrocardiogram (ECG) to assess eventually undergo revascularization,
for Abnormalities or evidence of ischaemia, taking a targeted most commonly with PCI.
clinical history to assess the clinical Context of the presentation,
and carrying out a targeted clinical examination to assess for Think secondary prevention: Once the final diagnosis of ACS
clinical and haemodynamic Stability. has been established, it is important to implement measures to

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