Contributions to Guideline and Consensus Papers

Epidemiological and genetic expertise on e.g. lipoproteins as well as chronic kidney disease resulted in several contributions in working groups of guidelines and consensus papers.

Lead

Florian Kronenberg, MD, MAE
Full Professor

+43 512 9003 70560
florian.kronenberg@i-med.ac.at

Lp(a) Consensus paper of the European Atherosclerosis Society (EAS)

The co-chairs Florian Kronenberg, Samia Mora and Erik Stroes together with further 19 Lp(a) experts from all the world provided an overview on the newest developments and recommendations on Lp(a). Based on epidemiological and genetic findings it is recommended that Lp(a) should be measured at least once in all adults to identify those with high cardiovascular risk. It is described how Lp(a) can be incorporate in clinical risk estimation and what to do in case of high Lp(a). The following graphical abstract describes the main points of the Lp(a) consensus paper.

Figure 1: Key points from the 2022 Lp(a) consensus statement. (Kronenberg et al., Eur. Heart J. 2022).

Risk Calculator

Furthermore, a new risk calculator is provided which considers besides the traditional risk factors also the risk that can be attributed to Lp(a) concentrations. Further information including slide sets can be found at the EAS website.

Kronenberg F, Mora S, Stroes ESG, Ference BA, Arsenault BJ, Berglund L, Dweck MR, Koschinsky M, Lambert G, Mach F, McNeal CJ, Moriarty PM, Natarajan P, Nordestgaard BG, Parhofer KG, Virani SS, von Eckardstein A, Watts GF, Stock JK, Ray KK, Tokgözoğlu LS, Catapano AL: Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis: a European Atherosclerosis Society consensus statement. Eur. Heart J. 43:3925-3946, 2022. PMID: 36036785 Journal Article

European Atherosclerosis Society task force consensus statement on rare dyslipidaemias

The European Atherosclerosis Society formed a task force to provide practical clinical guidance focusing on patients with extreme concentrations (either low or high) of plasma low-density lipoprotein cholesterol, triglycerides, or high-density lipoprotein cholesterol.

Hegele RA et al.: Rare dyslipidaemias, from phenotype to genotype to management: a European Atherosclerosis Society task force consensus statement. Lancet Diabetes Endocrinol 8: 50-67, 2020. PMID: 31582260

Consensus statement on the measurement of a lipid profile in non-fasting state

We recommended in joint consensus statement of the European Atherosclerosis Society (EAS) and European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) that non-fasting blood samples be routinely used for the assessment of plasma lipid profiles. Laboratory reports should flag abnormal values on the basis of desirable concentration cutpoints. Non-fasting and fasting measurements should be complementary but not mutually exclusive.

Nordestgaard BG et al: Fasting is not routinely required for determination of a lipid profile: clinical and laboratory implications including flagging at desirable concentration cut-points-a joint consensus statement from the European Atherosclerosis Society and European Federation of Clinical Chemistry and Laboratory Medicine. Eur Heart J 37: 1944-1958, 2016. PMID: 27122601

Consensus statement on the measurement of atherogenic lipoproteins

In this European Atherosclerosis Society – European Federation of Clinical Chemistry and Laboratory Medicine Consensus Panel we aimed to provide recommendations in two different papers to optimize atherogenic lipoprotein quantification for cardiovascular risk management. This is especially important considering the situation that with modern lipid-lowering therapies very low LDL cholesterol concentrations can be reached.

Langlois MR et al.: Quantifying Atherogenic Lipoproteins: Current and Future Challenges in the Era of Personalized Medicine and Very Low Concentrations of LDL Cholesterol. A Consensus Statement from EAS and EFLM. Clin Chem 64: 1006-1033, 2018. PMID: 29760220

Nordestgaard BG et al.: Quantifying atherogenic lipoproteins for lipid-lowering strategies: Consensus-based recommendations from EAS and EFLM. Atherosclerosis 294: 46-61, 2020. PMID: 31928713

KDIGO Clinical Practice Guideline for Lipid Management in Chronic Kidney Disease

The Kidney Disease: Improving Global Outcomes (KDIGO) organization developed clinical practice guidelines on lipid management for all adults and children with chronic kidney disease (CKD). Thirteen recommendations were obtained from the available evidence outlining a three-step management including assessment in all, treatment in many, and follow-up measurements in few.

Kidney Disease: Improving Global Outcomes (KDIGO) Lipid Work Group. KDIGO Clinical Practice Guideline for Lipid Management in Chronic Kidney Disease. Kidney Int., Suppl. 2013; 3: 259–305.

Wanner C, Tonelli M., Kidney Disease: Improving Global Outcomes Lipid Guideline Development Work Group Members: KDIGO Clinical Practice Guideline for Lipid Management in CKD: summary of recommendation statements and clinical approach to the patient. Kidney Int 85: 1303-1309, 2014. PMID: 24552851

Tonelli M, Wanner C, Kidney Disease: Improving Global Outcomes Lipid Guideline Development Work Group Members: Lipid management in chronic kidney disease: synopsis of the Kidney Disease: Improving Global Outcomes 2013 clinical practice guideline. Ann Intern Med 160: 182-189, 2014. PMID: 24323134

K/DOQI Clinical Practice Guidelines on Cardiovascular Disease in Dialysis Patients

In this document the work group provided guidelines on evaluation and management of cardiovascular diseases, on the management of cardiovascular risk factors and a state of science on novel and controversial topics of cardiovascular disease.

National Kidney Foundation. K/DOQI Clinical Practice Guidelines on Cardiovascular Disease in Dialysis Patients. Am. J. Kidney Dis. 45, Suppl. 3: S1-S154, 2005. PMID: 15806502

Publications

Hegele RA, Borén J, Ginsberg HN, Arca M, Averna M, Binder CJ, Calabresi L, Chapman MJ, Cuchel M, von Eckardstein A, Frikke-Schmidt R, Gaudet D, Hovingh GK, Kronenberg F, Lütjohann D, Parhofer KG, Raal FJ, Ray KK, Remaley AT, Stock JK, Stroes ES, Tokgözoğlu L, Catapano AL: Rare dyslipidaemias, from phenotype to genotype to management: a European Atherosclerosis Society task force consensus statement. Lancet Diabetes Endocrinol. 8:50-67, 2020. PMID: 31582260 Journal Article

Nordestgaard BG, Langsted A, Mora S, Kolovou G, Baum H, Bruckert E, Watts GF, Sypniewska G, Wiklund O, Borén J, Chapman MJ, Cobbaert C, Descamps OS, von Eckardstein A, Kamstrup PR, Pulkki K, Kronenberg F, Remaley AT, Rifai N, Ros E, Langlois M, European Atherosclerosis Society (EAS) and the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) joint consensus initiative: Fasting is not routinely required for determination of a lipid profile: clinical and laboratory implications including flagging at desirable concentration cut-points-a joint consensus statement from the European Atherosclerosis Society and European Federation of Clinical Chemistry and Laboratory Medicine. Eur. Heart J. 37:1944-1958, 2016. PMID: 27122601 Journal Article

Langlois MR, Chapman MJ, Cobbaert C, Mora S, Remaley AT, Ros E, Watts GF, Borén J, Baum H, Bruckert E, Catapano A, Descamps OS, von Eckardstein A, Kamstrup PR, Kolovou G, Kronenberg F, Langsted A, Pulkki K, Rifai N, Sypniewska G, Wiklund O, Nordestgaard BG, European Atherosclerosis Society (EAS) and the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Joint Consensus Initiative: Quantifying atherogenic lipoproteins: Current and future challenges in the era of personalized medicine and very low concentrations of LDL cholesterol. A consensus statement from EAS and EFLM. Clin. Chem. 64:1006-1033, 2018. PMID: 29760220 Journal Article

Nordestgaard BG, Langlois MR, Langsted A, Chapman MJ, Aakre KM, Baum H, Borén J, Bruckert E, Catapano A, Cobbaert C, Collinson P, Descamps OS, Duff CJ, von Eckardstein A, Hammerer-Lercher A, Kamstrup PR, Kolovou G, Kronenberg F, Mora S, Pulkki K, Remaley AT, Rifai N, Ros E, Stankovic S, Stavljenic-Rukavina A, Sypniewska G, Watts GF, Wiklund O, Laitinen P, European Atherosclerosis Society (EAS) and the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Joint Consensus Initiative: Quantifying atherogenic lipoproteins for lipid-lowering strategies: Consensus-based recommendations from EAS and EFLM. Atherosclerosis 294:46-61, 2020. PMID: 31928713 Journal Article

Wanner C, Tonelli M, Kidney Disease: Improving Global Outcomes Lipid Guideline Development Work Group Members: KDIGO Clinical Practice Guideline for Lipid Management in CKD: summary of recommendation statements and clinical approach to the patient. Kidney Int. 85:1303-1309, 2014. PMID: 24552851 Journal Article

K/DOQI Workgroup: K/DOQI clinical practice guidelines for cardiovascular disease in dialysis patients. Am. J. Kidney Dis. 45:S1-153, 2005. PMID: 15806502 Journal Article