65 , 1970-2004

( 100.000 )

CEP III :

1. ( >45 . >55 .)
2.
1 <55
1 <65
3. LDL-C (>130mg/dl)
4. HDL-C (<40mg/dl)
5. ( >140/90 )
6.
7.

HDL-C > 60mg.dL .

 ;

.
:
- (TC)
- (LDL-C)
- (TG)
K :
- (HDL-C)

ATP III Lipid and

Lipoprotein Classification
LDL C (mg/dl)
<100
100-129
Optimal
130-159
160-189
>190

Optimal
Near/Above
Borderline High
High
Very High

Triglycerides (mg/dl)
< 150
150 - 199

Optimal
Borderline High

200 - 499

High

500
Very high :
pancreatitis
risk

HDL C (mg/dl)
< 40 Low
> 60 High (Desirable)

NCEP, Adult Treatment Panel III. JAMA. 2001;285:2486-2497.

 :
/
:
1. ( ): TG

2.
. (1/1.000.000 ): LDL-C
. (1/500 ): LDL-C
3.
(1/300 ): LDL-C, TG, HDL-C
4. (1/2.000 ): TG
5. HDL-C:
-C HDL-C.

:
1.
2.
3.
4. -
5.
6.

7.
.
.
.
.
. -
.
.
.
. -



KAN:

( )

Guidelines of the Hellenic Society of Atherosclerosis for the diagnosis and treatment of dyslipidemia.
M. Elisaf, Ch. Pitsavos,E. Liberopoulos, V. Athyros ,Hellenic Journal of Atherosclerosis 2(3):163168

 AHA/AAC 2013 ??

(ASCVD Risk)
.

( )

(4 )
LDL-C & Non-HDL-C
treat to target

 & SC/EAS 2011 ??

(eartscore)

4



LDL-C, Non-HDL-C,
HDL-C, G (treat to target)

 >21

LDL

LDL-C 70-189mg/dl
40-75

LDL-C 70-189mg/dl
40-75

LDL-C 190mg/dl

10

10

<7,5%

7,5%

Stone NJ, et al.

2013 ACC/AHA Blood Cholesterol Guidelines

1
.
56

: 178
cm, : 96
kg,
:30.3
kg/m
(grade I)

: 105
cm

(15
/)

~ 2-3
/
:

,
2

150mg/

:140/90mmH
g : 78/min,
S1,S2 ,
(-),
:SR,
,
:,
.
:

TC : 257mg/dl,
LDL-C : 167mg/dl
TG : 249mg/dl,
HDL-C : 40mg/d,
Glu: 102mg/dl,
BUN : 16mg/dl,
Creat : 0,82mg/dl,
GFR:136.6
AST : 25U/l,
ALT : 28U/l,
GT :
38U/l,
CK : 57U/l,
TSH :
2,3mIU/l

 ?
56 >45

LDL-C (=167>130mg/dl)
22%
? HDL-C(=40mg/dl)
A TG
(249>150mg/dl)39.75%

:140/90mmH
g : 78/min,
S1,S2 ,
(-),
:SR,
,
:,
.
:

TC : 257mg/dl,
LDL-C : 167mg/dl
TG : 249mg/dl,
HDL-C : 40mg/d,
Glu: 102mg/dl,
BUN : 16mg/dl,
Creat : 0,82mg/dl,
GFR:136.6
AST : 25U/l,
ALT : 28U/l,
GT :
38U/l,
CK : 57U/l,
TSH :
2,3mIU/l

 ?
1.
2.
3.
4.

1 ?
?
?
score
?
5.
,
,
score
?

ASCVD Risk Evaluation

10-year risk of
atherosclerotic
cardiovascular
disease:

22.8%

10-year risk in a
similar patient with
optimal risk
factors :

3.9%

4
1.

2.

LDL-C > 190 mg/dl.

3.

40-75 LDL-C 70-189 mg/dl .

4.

40-75 LDL-C 70-189 mg/dl

10 > 7,5%.

4
1.

2.

LDL-C > 190 mg/dl.

3.

40-75 LDL-C 70-189 mg/dl .

4.

40-75 LDL-C 70-189 mg/dl

10 > 7,5%.

 LDL-C 70-189mg/dl
( )

10 ASCVD
score Pool Cohort Risk Assesment Equations.

1)

10 7,5% :

1)

().

10 < 7,5% :

(C).
Y , .,
().
Stone NJ, et al.
2013 ACC/AHA Blood Cholesterol Guidelines

 :
LDL-C

Rosuv
a
Atorva Lova
statin statin statin

Prava
statin

Simva
statin

22%

30%

Fluva
statin

10 mg

39%

39%

20 mg

46%

43%

27%

32%

38%

22%

40 mg

55%

50%

32%

34%

41%

25%

60%

42%

47%

36%

80 mg

Physicians Desk Reference. 55th ed. Montvale, NJ: Medical Economics, 2001

 5-10%

< 5gr/.
< 30% . ,..

30min/. 5 /. 150min/.

10mg x1

(kg)

96

84

- 12.5%

(kg/m2)

30.3

26.5

- 12.5%

A (mmHg)

140 / 90

135/80

- 5 mmHg

TC (mg/dL)

257

162

- 36,9%

LDL-C (mg/dL)

167

90

- 46,10%

HDL-C (mg/dL)

40

46

+ 16%

TG (mg/dL)

249

142

- 42,9%

Fast.Gluc
(mg/dL)

102

98

- 3,92%

2
44

(1
/)
1
/
.

182 cm, :106Kg

:32kg/m2
:100cm

:130/80mmHg
: 74/min, S1,S2
,
(-),
:SR, ,
:,
U/s:

.:

TC : 229mg/dl,
LDL-C : 127mg/dl
TG : 270mg/dl,
HDL-C : 48mg/d,
Glu: 186mg/dl, HbA1c:8.6%
BUN :
34mg/dl,
Cr :
0.9mg/dl,GFR:157.0ml/min
AST : 42U/l,
ALT : 49U/l,
GT :
74U/l,
CK : 76U/l,
TSH :
1.9mIU/l

ASCVD
10-year risk of
atherosclerotic
cardiovascular
disease:

12.1%

10-year risk in a
similar patient with
optimal risk factors :

1%

 ? ?
? ,
?

 :
LDL-C

Rosuv
a
Atorva Lova
statin statin statin

Prava
statin

Simva
statin

22%

30%

Fluva
statin

10 mg

39%

39%

20 mg

46%

43%

27%

32%

38%

22%

40 mg

55%

50%

32%

34%

41%

25%

60%

42%

47%

36%

80 mg

Physicians Desk Reference. 55th ed. Montvale, NJ: Medical Economics, 2001


3
!
:

()

COMETS :

Stalenhoef A F et al. Eur Heart J 2005;26:2664-2672

 ?
1.
2.
3.
4.

- -
-3

 TG < 400 mg/dl,

,

!!!
()
!
&

(kg)

106

88

- 16.98%

(kg/m2)

30.3

26.6

- 12.2%

A (mmHg)

130 /80

128/80

- 2mmHg

TC (mg/dL)

229

185

- 19.2%

LDL-C (mg/dL)

127

107

- 15.74%

HDL-C (mg/dL)

48

49

+ 2%

TG (mg/dL)

270

145

- 46,29%

Fast.Gluc
(mg/dL)

186

118

- 36.56%

 ,

: ,
, , ()

3
2
1

65
: 162cm ,
: 84kg,
: 32kg/m2

3

3,

8

:
100mg/d,
/HCT
5/25mg,
850mg//,

10mg

:135/82mmHg
: 68/min, S1,S2
,
(-),
:SR, ,
:,
.:

TC : 188mg/dl,
LDL-C : 109 mg/dl
TG : 135 mg/dl,
HDL-C : 52 mg/d,
Glu: 115mg/dl,
HbA1c:6.8%
BUN : 44mg/dl,
Cr :
1.1mg/dl,GFR:.67.6ml/min
AST : 45U/l,
ALT : 16U/l,
GT :
64U/l,
CK : 145U/l,
TSH :
2.6mIU/l

10-year risk of
atherosclerotic
cardiovascular
disease:

14.2%

10-year risk in a
similar patient with
optimal risk factors :

4%

 ?
1. ,
( 10mg)
2. 20mg
3. 10mg
4. 40mg

(kg)

84

78

- 7.14%

(kg/m2)

32

29.7

- 7.18%

A (mmHg)

135 /82

128/80

- 7mmHg

TC (mg/dL)

188

168

- 10.64%

LDL-C (mg/dL)

109

96

- 11.9%

HDL-C (mg/dL)

52

53

+ 2%

TG (mg/dL)

135

116

- 14.1%

Fast.Gluc
(mg/dL)

188

100

- 46.8%

 30min
40mg
40 mg +


!!!