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CODAP: um consenso multidisciplinar sobre a definição,diagnóstico e tratamento da dislipidemia aterogénica em Portugal
Authors:Alberto Mello e Silva  Carlos Aguiar  João Sequeira Duarte  Luciana Couto  Manuel Teixeira Veríssimo  Pedro Marques da Silva
Institution:1. Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal;2. Sociedade Portuguesa de Aterosclerose, Lisboa, Portugal;3. Hospital Santa Cruz, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal;4. MEDCIDS‐Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, Universidade do Porto, Porto, Portugal;5. Faculty of Medicine, Universidade de Coimbra, Coimbra, Portugal;6. Núcleo de Investigação Arterial, Medicina 4, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, Lisboa, Portugal
Abstract:Introduction and aimsAtherogenic dyslipidemia is an important contributor to residual cardiovascular (CV) risk, but it is underdiagnosed and undertreated. This study aimed to assess the opinion of Portuguese experts to generate a consensus concerning the diagnosis and treatment of atherogenic dyslipidemia, as well as to contribute toward standardization of clinical practice in this disorder.MethodsThe study consisted in the application of a questionnaire to an expert panel, following a modified Delphi methodology.ResultsThe majority (88.4%) of the proposed items were found to be consensual. The expert panel recognized the importance of the atherogenic dyslipidemia phenotype, the role played by low‐density lipoprotein cholesterol and non‐high‐density lipoprotein cholesterol as risk markers and therapeutic targets, the choice of statins as first‐line lipid‐lowering drugs, and the value of associating statins with fenofibrate as a means to reduce residual CV risk. However, the role played by triglycerides in CV risk and the therapeutic value of fibrates lacked consensus. Taking into consideration the state of the art and the opinions expressed in this study, the scientific committee developed a treatment algorithm aimed to improve the perception and treatment of atherogenic dyslipidemia.ConclusionsThe experts involved in this study were shown to be familiar with the concept and the importance of atherogenic dyslipidemia. The few situations in which a consensus could not be found were mainly related to the interpretation and/or relevance of the available evidence.
Keywords:Autor para correspondência    Dislipidemia aterogénica  c‐LDL  Colesterol não‐HDL  Triglicerídeos  Fenofibrato  Risco cardiovascular residual  Atherogenic dyslipidemia  Low‐density lipoprotein cholesterol  Non‐high‐density lipoprotein cholesterol  Triglycerides  Fenofibrate  Residual cardiovascular risk
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