concentration 1.five to five.6 mmol/l (13599 mg/dl) and high cardiovascular threat resulted in a reduction of incidence of cardiovascular events by 25 [147], European professionals suggested adding EPA to a statin in such circumstances (IIaB) [9]. A fibrate may also be added to a statin in major prevention (IIbB) as well as in high-risk patients in whom LDL-C concentration corresponds to the target and TG concentration exceeds 2.3 mmol/l (IIbC) [9]. The authors of those guidelines normally accept European suggestions, even so, pointing out a substantially greater function of fibrates in high-risk individuals, which may possibly be incredibly efficient in reduction of the danger of micro- and macrovascular complications (recommendation level IIaB), along with the fact that DNMT1 list icosapent ethyl is still unavailable on Polish market place; hence, the suggestions contain for the first time omega-3 acids in high doses (a minimum of 2 g/day recommendation level IIbC) (see sections on omega-3 acids and fibrates; Table XXI and Figure 11). If TG concentration is 5.6 mmol/l (500 mg/ dl), therapy is initiated with fibrate to speedily decrease its concentration and reduce the danger of AP. If chylomicrons are present in the fasting state and VLDL-TG concentration is elevated (multifactorial or polygenic chylomicronaemia), combination pharmacotherapy having a fibrate and n-3 PUFAArch Med Sci 6, October /PoLA/CFPiP/PCS/PSLD/PSD/PSH suggestions on diagnosis and therapy of lipid issues in PolandTable XXI. Recommendations on treatment of hypertriglyceridaemia Recommendation Statins are advised as first-line therapy to minimize the risk of CVD in high-risk people with hypertriglyceridaemia (TG two.3 mmol/l/ 200 mg/dl). In a minimum of high-risk patients with TG 1.7 mmol/l ( 150 mg/dl) despite statin therapy, icosapent ethyl (two 2 g/day) in mixture using a statin must be considered. In a minimum of high-risk individuals with TG 2.3 mmol/l ( 200 mg/dl) despite statin therapy, omega-3 acids (PUFA inside a dose of 2 to four g/day) in mixture using a statin may perhaps be thought of. In patients in major prevention who achieved their LDL-C ambitions with persistent TG concentration two.3 mmol/l ( 200 mg/dl), fenofibrate in mixture with a statin may well be considered. In high-risk individuals who accomplished their LDL-C goals with persistent TG concentration 2.3 mmol/l ( 200 mg/dl), fenofibrate in mixture having a statin must be regarded.Improved danger of atrial CB2 Compound fibrillation ought to be kept in mind.Class I IIa IIb IIb IIaLevel B C C B BHigh and pretty high-risk individuals with elevated TG TG 2.three and five.six mmol/l ( 200 and 500 mg/dl) right after life style modification Yes On a high-dose statin No Use a high-dose statinSTePYesIf TG ten mmol/l ( 885 mg/dl), consider a genetic causeLDL-C target achievedNoIncrease statin dose ezetimibeTG two,three and five.six mmol/l ( 200 and 500 mg/dl) Monitor LDL-C and TG for four weeksSTePType two diabetes with ASCVDType 2 diabetes devoid of ASCVDAF riskConsider high-dose omega-3 acids (icosapent ethyl)Take into account introduction of fenofibrateTG aim achieved No Look at introduction of fenofibrateTG goal achieved No Take into account high-dose omega-3 acids (icosapent ethyl)Figure 11. Recommendations on therapy of hypertriglyceridaemia (adapted and modified, according to the EAS Professional Opinion 2021 [140])Arch Med Sci six, October /M. Banach, P. Burchardt, K. Chlebus, P. Dobrowolski, D. Dudek, K. Dyrbu, M. Gsior, P. Jankowski, J. J iak, L. Klosiewicz-Latoszek, I. Kowalska, M. Malecki, A. Prejbisz, M. Rakowski, J. Rysz, B. Solnica, D