The importance of nonstatin therapies for LDL-cholesterol lowering in the management of very high and high atherosclerotic cardiovascular risk

Česká verzia

Authors: Daniel Pella
Authors place of work: II. kardiologická klinika LF UPJŠ a Východoslovenský ústav srdcovocievnych chorôb, a. s., Košice
Published in the journal: AtheroRev 2023; 8(2): 77-83
Category: Reviews

Summary

The role of LDL-cholesterol (LDL-C) in the pathogenesis of atherosclerosis and in the subsequent increase in the risk of atherosclerotic cardiovascular disease (ACVD) is unquestionable. The only subject of expert debate is how significantly and in what way this level needs to be reduced. However, there is also general agreement that this should be conditional on the level of cardiovascular (CV) risk of the individual. This is where opinions start to diverge – who are the patients with the highest CV risk, and who, conversely, are those who pharmacologically just need to be treated less intensively? Differences also exist in opinions about how early to start treatment, how long to continue it, and in what manner. In most cases, the recommendations of professional societies are based on Evidence Based Medicine (EBM), which stratifies individual candidates for treatment according to the level of evidence and classes of recommendations. Nevertheless, there are many situations in clinical practice in which management may not be completely specified in the recommendations. The aim of this review is to help improve the situation in the secondary prevention of atherosclerosis by highlighting the role of non-statin drugs and the potential for their use in light of the benefits demonstrated to date and the limitations of their use.

Keywords:

hypercholesterolemia – hypolipidemic drugs – LDL-cholesterol – non-statin drugs

Zdroje

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