당뇨병 환자에서 2013 ACC/AHA Cholesterol Guideline의 문제점 |
이문규 |
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2013 ACC/AHA Guidelines. |
Moon Kyu Lee |
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. leemk@skku.edu |
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Abstract |
The new 2013 ACC/AHA Guideline is quite different from the previous NCEP-ATP III or ESC/EAS guidelines. Although the guideline is simplified and aimed at prevention of ASCVD rather than control of lipid levels, it also raises many questions and debates. If Koreaadopts the new guideline, the number of people to be treated with statins will increase dramatically, which would pose a large costburden on the medical system. Young people with high lifetime ASCVD risk according to the Pooled Cohort Equation would be administered high- or moderate-intensity statins at an earlier stage, and the older generations would likely be overtreated. The equation should be validated in populations other than non-Hispanic whites and African-Americans before final approval as a valid tool for risk calculation. Studies of Korean populations, including several observational epidemiologic studies and RCTs, are required to validate the new guideline in Korea. |
Key Words:
2013 ACC/AHA Guideline, Statin, Cholesterol, Diabetes mellitus |
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