AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY GUIDELINES FOR MANAGEMENT OF DYSLIPIDEMIA AND PREVENTION OF CARDIOVASCULAR DISEASE - EXECUTIVE SUMMARY
AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY GUIDELINES FOR MANAGEMENT OF DYSLIPIDEMIA AND PREVENTION OF CARDIOVASCULAR DISEASE - EXECUTIVE SUMMARY
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DOI：
10.4158/ep171764.gl
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发表时间：
2017-04-01
影响因子：
4.2
通讯作者：
Davidson, Michael
中科院分区：
文献类型：
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作者：
Jellinger, Paul S.;Handelsman, Yehuda;Davidson, Michael
目标：这些指南的制定是由美国临床内分泌学家协会（AACE）董事会和美国内分泌学会（ACE）董事会授权的，并遵守已发布的AACE协议，以标准化生产临床实践指南（CPGs.Methods）：每个建议都是基于对临床证据的认真审查，并透明地纳入主观因素。本文件的执行摘要包含87项建议，其中45项为A级（51.7%），18项为B级（20.7%），15项为C级（17.2%），9项为D级（10.3%）。这些详细的、基于证据的建议允许基于细微差别的临床决策，解决现实世界医疗保健的多个方面。随后的附录中提供的证据基础为执行摘要建议提供了相关的支持信息。本更新包含695条引文，其中202条（29.1%）为证据等级（EL）1（强），137（19.7%）为EL 2（中间体），119（17.1%）为EL 3（弱）型，237（34.1%）为EL 4（无临床证据）。结论：该CPG是内分泌学家、其他医疗保健专业人员、监管机构和健康相关组织可以用来降低血脂异常风险和后果的实用工具。它为各种脂质紊乱患者的筛查、风险评估和治疗建议提供指导。这些建议强调了在某些个体中治疗低密度脂蛋白胆固醇（LDL-C）的重要性，以降低先前推荐的目标，并支持测量冠状动脉钙评分和炎症标志物，以帮助分层风险。特别考虑糖尿病、家族性高胆固醇血症、女性和儿童血脂异常患者。提供临床和成本效益数据以支持治疗决策。
Objective: The development of these guidelines is mandated by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPGs).Methods: Each Recommendation is based on a diligent review of the clinical evidence with transparent incorporation of subjective factors.Results: The Executive Summary of this document contains 87 Recommendations of which 45 are Grade A (51.7%), 18 are Grade B (20.7%), 15 are Grade C (17.2%), and 9 (10.3%) are Grade D. These detailed, evidence-based recommendations allow for nuance-based clinical decision making that addresses multiple aspects of real-world medical care. The evidence base presented in the subsequent Appendix provides relevant supporting information for Executive Summary Recommendations. This update contains 695 citations of which 202 (29.1 %) are evidence level (EL) 1 (strong), 137 (19.7%) are EL 2 (intermediate), 119 (17.1%) are EL 3 (weak), and 237 (34.1%) are EL 4 (no clinical evidence).Conclusion: This CPG is a practical tool that endocrinologists, other healthcare professionals, regulatory bodies and health-related organizations can use to reduce the risks and consequences of dyslipidemia. It provides guidance on screening, risk assessment, and treatment recommendations for a range of patients with various lipid disorders. These recommendations emphasize the importance of treating low-density lipoprotein cholesterol (LDL-C) in some individuals to lower goals than previously recommended and support the measurement of coronary artery calcium scores and inflammatory markers to help stratify risk. Special consideration is given to patients with diabetes, familial hypercholesterolemia, women, and pediatric patients with dyslipidemia. Both clinical and cost-effectiveness data are provided to support treatment decisions.