1

.

.

 LDL 112 mg/dl,

..

 ,
82, ,
.
. ,

.

 :
( 3
/ 15)
,
( )

:


(BMI>29,
. :98cm

Hct: 40%
Glu:106mg/dl
Ur:50mg/dl
Cr:1,1mg/dl
Chol:220mg/dl
HDL:98mg/dl
LDL:112mg/dl
SGOT:100IU/L
SGPT:75IU/L
GT:140IU/L
TG:150mg/dl

12h

stress

T CHOL, HDL CHOL, TRG

LDL CHOL=T CHOL - HDL CHOL - TRG/5
( TRG<400mg/dl)

TC = HDL-C + LDL-C + VLDL-C

non HDL-C = TC HDL-C = LDL-C + VLDL-C
=
non HDL-C

+ 30mg/dl
LDL-C


ALT(SGPT)
AST(SGPT)

, , ,
:

(
50
)


(
)

(, )

(,
, , )

- (-GT)


( ,
, ,
Ca ) (+
).


,
,
.

Primary Risk Factors For CHD

Hypertension
Diabetes
Mellitus

Cigarette
smoking

Wood D, et al. Eur Heart J. 1998;19:1434-1503.

CHD
Dyslipidemia

Age
Male
gender

Family
history
of CHD
Non modifiable
Modifiable

 ,
(
)
.
,

- ()
-

 SCORE
10

Hellenic Journal of Atherosclerosis 2014;5(3):

151-163


LDL-CHOL

Hellenic Journal of Atherosclerosis 2014;5(3):

151-163


LDL-C

:
, 2, 1 >40 ,
- ,
Hellenic Heart SCORE>10%

LDL-C
>50%

LDL-C <70
mg/dL

:
SCORE 5-10%,
1
,
.
,

LDL-C <100
mg/dL

Hellenic Journal of Atherosclerosis 2014;5(3):

151-163

-:
SCORE <5%

LDL-C <115
mg/dL

1.
2.
3.
4.
5. HELLENIC SCORE >10%

Hellenic Journal of Atherosclerosis 2014;5(3):

151-163


:
LDL

LDL

>50%

<70 mg/dL

Hellenic Journal of Atherosclerosis 2014;5(3):

151-163

 TRG >200 mg/dL

: LDL
CHOL
:
non HDL CHOL

 LDL-C

LDL-C

,
3-5 (
< 60 ml/min/1,73m2)
LDL < 70 mg/dl

SCORE
SCORE 10% LDL < 70 mg/dl
SCORE 5-9% LDL < 100 mg/dl
SCORE 1-4%
Eur Heart J 2011;32:1769-818

(..
Pooled Cohort Equation

).

2014

3x

>
3

: (Child-Pugh
score > 7)

,

(n=342)
(n=2.245)

Gastroenterology 2004;126:1287-92

WOSCOPS, CARE
LIPID,

(n=317) placebo (n=262)

Circulation 2002;105:2341-6

:

ALT

1. Browning JD. Hepatology 2006;44:466-471

2. Ekstedt M et al. J Hepatol 2007:47:135-141


%
.

LDL

HDL

25-30

30-60 5-15

20-45

10-25

5-25

20-50

10-25

15-30 0-5

0-15

10-25

20-30 10-35

30-50

15

20

5-10

10-25

1
( )

2
()

(, )

Hellenic Journal of Atherosclerosis 2014;5(3):

151-163

LDL
CHOL

***

LDL CHOL

**

LDL CHOL

HDL
CHOL CHOL

HDL CHOL

+
-3

LDL CHOL, HDL

CHOL

* >500 mg/dL / -3

**

*** 6% LDL CHOL

10-80 mg

20-80 mg

1-4 mg

10-40 mg

5-40 mg

5-40 mg

20-80 mg

(10/10, 10/20 10/40 mg),
(40/160 mg),
(20/145 40/145 mg).

Hellenic Journal of Atherosclerosis 2014;5(3):

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2013


American Heart Association 2013

LDL
50%

A: 40 80 mg
: 20 40 mg

 : ;

=
,

,

:
10%15%

Harper CR, JacobsonTA. Evidencebased management of statin myopathy. Atheroscler Rep. 2010; 12:
322330
Arca M, Pigna G. Treating statinintolerant patients. Diabetes, Metabolic syndrome and Obesity. Targets
and Therapy. 2011; 4: 155166

(SGOT, SGPT > 3x)

: , ,

: , , ,

Silva MA, Swanson AC, Gandhi PJ, Tataronis GR. Statinrelated adverse events: a metaanalysis,
. Clin Ther.2006; 28: 2635

 &

- (1994-2009), 13

255
4
, 1

1 ,
5
& 5

Lancet 2010;375:735-742


..

??

(guidelines)
(AHA)
(ACC),1
, ,

, , ,

40-75 !

 ASCOT-LLA

10.305
(, , , )

2003, 3.3 5 ,
, (36% ),

.

4.605 .

36%
;;;;;

.
2 100
3 100

1%.
100
!
, 36% ,
1% ,
!
!



40-75 :
1.
2. LDL >_190 mg/dl
3. 1 2 LDL >70 mg/dl
4. 10- > 7,5% LDL
> 70 mg/dl

:

(Cr > 2.0)
:

()
,
Erythromycin, ()

> 80

grape fruit

Hellenic Journal of Atherosclerosis 2014;5(3):

151-163

..



, ?