Implications for REDUCE IT in clinical practice.

Abstract

Statin therapy is effective in primary and secondary prevention, but substantial residual risk remains on statin treatment, especially among high risk and very high risk patients. Add-on therapy with ezetimibe and proprotein convertase subtilisin /kexin type 9 (PCSK9) inhibitors provides additional risk reduction through further reduction in low density lipoprotein cholesterol. Elevated triglycerides/triglyceride rich lipoproteins contribute to atherogenesis and to the residual risk on statin therapy. Addition of icosapent ethyl to statins has recently been shown to markedly lower risk of ASCVD events in patients with established atherosclerotic CVD (ASCVD) and high risk patients with type II diabetes mellitus. These data are discussed in the context of current guidelines and synthesized in a decision pathway to guide combination lipid-lowering therapy in patients at high ASCVD risk.

• Authors: Vera Bittner
• Journal: Progress in cardiovascular diseases (Prog Cardiovasc Dis) 2019 Sep - Oct Vol. 62 Issue 5 Pg. 395-400 ISSN: 1873-1740 [Electronic] United States
• PMID: 31715195 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2019 Elsevier Inc. All rights reserved.

Chemical References

• Biomarkers
• Cholesterol, LDL
• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• PCSK9 Inhibitors
• Serine Proteinase Inhibitors
• Triglycerides
• eicosapentaenoic acid ethyl ester
• Eicosapentaenoic Acid
• PCSK9 protein, human
• Proprotein Convertase 9
• Ezetimibe

Topics

• Biomarkers (blood)
• Cardiovascular Diseases (diagnosis, epidemiology, prevention & control)
• Cholesterol, LDL (blood)
• Drug Therapy, Combination
• Dyslipidemias (blood, diagnosis, drug therapy, epidemiology)
• Eicosapentaenoic Acid (adverse effects, analogs & derivatives, therapeutic use)
• Ezetimibe (adverse effects, therapeutic use)
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (adverse effects, therapeutic use)
• PCSK9 Inhibitors
• Practice Guidelines as Topic
• Proprotein Convertase 9 (metabolism)
• Randomized Controlled Trials as Topic
• Risk Factors
• Serine Proteinase Inhibitors (adverse effects, therapeutic use)
• Treatment Outcome
• Triglycerides (blood)