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REFLECTIONS
Dyslipidaemia
Dyslipidaemia Global Newsletter #9 2025

Various tools and strategies are highlighted for the diagnosis surgery, and pharmacotherapy. Future advancements in clinical
and management of SMD. The authors describe several risk scores, polygenic risk scores (PRS), and microbiome-based
diagnostic tools and/or biomarkers that can be used to assess treatments hold promise for further personalising risk assessment,
Dyslipidaemia
each SMD component. Management of SMD involves lifestyle predicting SMD progression, and guiding preventive interventions
changes, i.e. improved diet quality, calorie restriction, and even earlier in life.
regular physical activity. Additionally, metabolic/bariatric surgery
is an option for severe obesity, and pharmacotherapy includes
modern agents like GLP-1 receptor agonists, SGLT2 inhibitors,
lipid-lowering medications like statins and PCSK9 inhibitors,
antihypertensives, and anti-inflammatory drugs like low-dose
colchicine. High-intensity statins are also the first-line therapy
for achieving reductions in LDL-C, apoB, and non-HDL-C.
Several future therapies have been found effective in treating
hypertriglyceridaemia (antisense oligonucleotides, siRNA-
based therapies, monoclonal antibodies targeting apoCIII and
ANGPTL3) but further studies are required to establish whether
targeting these pathways will result in reducing the residual
cardiovascular risk in individuals with SMD-related dyslipidaemia. CLICK HERE
TO VIEW A SHORT VIDEO DISCUSSING
This EAS consensus statement provides a comprehensive, THE MAIN POINTS OF THE GUIDELINES
pathophysiology-based staging system for SMD, emphasising FROM @GUIDELINECENTRAL.
its multiorgan nature and progressive course. The prevalence
data from the UK Biobank underscore the significant burden of
early-stage SMD in the population. The proposed framework CLICK HERE
aims to facilitate a holistic and individually tailored approach to FOR THE LINK TO FULL ARTICLE
clinical management, integrating lifestyle modifications, metabolic

Coronary artery calcium testing-too early, too late, too often.
Zheutlin AR, et al. JAMA Cardiol. 2025;10(5):503-509.

Coronary artery calcium (CAC) testing is a valuable tool used to assess the burden of advanced atherosclerosis and improve
individual-level risk prediction for future ASCVD. Measured by a computed tomography (CT) scan in under 15 minutes with low
radiation exposure, the CAC score quantifies calcium deposition in atherosclerotic lesions and is compared to normative data by
age, sex, and race. While traditional ASCVD risk factors (such as diabetes, smoking, etc.) are associated with CAC, the score offers
additional insight into incident ASCVD risk, particularly for adults without a history of ASCVD and not taking statin therapy.

Clinical scenarios for when a CAC level of 0 may impact clinical decision-making

Scenario Description

1 Statin-naive patients hesitant to initiate statin therapy and require more information regarding their individual
risk vs benefit of statin therapy

Patients previously trialed on statin therapy who were unable to tolerate statin therapy due to side effects and are
2
considering retrialing statin therapy
Adults aged 55-80 y for men or 60-80 y for women who do not have significant cardiovascular risk factors and
3
are unclear whether a statin is likely to benefit them
Adults aged 40-55 y with a calculated 10-y risk of ASCVD of 5% to <7.5% by the PCE that have other factors
4
that increase their ASCVD risk

ASCVD, atherosclerotic cardiovascular disease; PCE, pooled cohort equation.

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