I am 55 years old, my cholesterol is 6.5 mmol/l and I do not want statin
Authors:
Jan Piťha 1; Michal Vrablík 2
Authors place of work:
Laboratoř pro výzkum aterosklerózy, Centrum experimentální medicíny, Klinika kardiologie, Kardiocentrum, IKEM
1; Centrum preventivní kardiologie, III. interní klinika – endokrinologie a metabolismu 1. LF UK a VFN v Praze
2
Published in the journal:
AtheroRev 2024; 9(1): 42-46
Category:
Reviews
Summary
In this article, we present a systematic approach to a person who has had a lipidogram measured for the first time at the age of 55 and has moderately elevated LDL cholesterol concentrations and who has significant concerns about the use of 3-methyl 3-glutaryl CoA reductase inhibitors (statins). In addition to the traditional options available in a routine outpatient examination, we also briefly mention other options including genetic testing and imaging methods and discuss their possible contribution to solving this situation. In additon, we present an overview of the available non-statin therapy.
Keywords:
statins – dyslipidemia – detection of cardiovascular risk
Zdroje
Podfuk s cholesterolem. Dostupné z WWW: <https://www.celostnimedicina.cz/podfuk-s-cholesterolem>.
Fahed AC, Natarajan P. Clinical applications of polygenic risk score for coronary artery disease through the life course. Atherosclerosis 2023; 386: 117356. Dostupné z DOI: <https://doi.org/10.1016/j.atherosclerosis.2023.117356>.
Marais AD. Apolipoprotein E and Atherosclerosis. Curr Atheroscler Rep 2021; 23(7): 34. Dostupné z DOI: <https://doi: 10.1007/s11883–021–00933–4>.
Griffin M, Nicolaides AN, Belcaro G et al. Cardiovascular risk assessment using ultrasound: the value of arterial wall changes including the presence, severity and character of plaques. Pathophysiol Haemost Thromb 2002; 32(5–6): 367–370. Dostupné z DOI: <https://doi: 10.1159/000073602>.
Saba L, Antignani PL, Gupta A et al. International Union of Angiology (IUA) consensus paper on imaging strategies in atherosclerotic carotid artery imaging: From basic strategies to advanced approaches. Atherosclerosis 2022; 354: 23–40. Dostupné z DOI: <https://doi: 10.1016/j.atherosclerosis.2022.06.1014>.
Cournot M, Bura A, Cambou JP et al. Arterial ultrasound screening as a tool for coronary risk assessment in asymptomatic men and women. Angiology 2012; 63(4): 282–288. Dostupné z DOI: <https://doi: 10.1177/0003319711414865>.
Griffin M, Nicolaides A, Tyllis T et al. Carotid and femoral arterial wall changes and the prevalence of clinical cardiovascular disease. Vasc Med 2009; 14(3): 227–232. Dostupné z DOI: <https://doi: 10.1177/1358863X08101542>.
Hecht HS. Coronary artery calcium scanning: past, present, and future. JACC Cardiovasc Imaging 2015; 8(5): 579–596. Dostupné z DOI: <https://doi: 10.1016/j.jcmg.2015.02.006>.
Vrablík M, Cífková R, Tuka V et al. Doporučený postup Evropské kardiologické společnosti pro prevenci kardiovaskulárních onemocnění v klinické praxi 2021. Souhrn dokumentu připravený Českou kardiologickou společností. Cor Vasa 2022; 64(2): 165–211. Dostupné z DOI: <https://doi: 10.33678/cor.2022.035>.
Estruch R, Ros, E, Salas-Salvadó J et al. PREDIMED Study Investigators. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med 2013; 368(14): 1279–1290. Dostupné z DOI: <https://doi: 10.1056/NEJMoa1200303>.
Keith M, Kuliszewski MA, Liao C, et al. A modified portfolio diet complements medical management to reduce cardiovascular risk factors in diabetic patients with coronary artery disease. Clin Nutr 2015; 34(3): 541–548. Dostupné z DOI: <https://doi: 10.1016/j.clnu.2014.06.010>.
Yebyo HG, Aschmann HE, Kaufmann M et al. Comparative effectiveness and safety of statins as a class and of specific statins for primary prevention of cardiovascular disease: A systematic review, meta-analysis, and network meta-analysis of randomized trials with 94,283 participants. Am Heart J 2019; 210: 18–28. Dostupné z DOI: <https://doi: 10.1016/j.ahj.2018.12.007>.
Cicero AFG, Colletti A, Bajraktari G et al. Lipid-lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel. Nutr Rev 2017; 75(9): 731–767. Dostupné z DOI: <https://doi: 10.1093/nutrit/nux047>.
Giugliano RP, Cannon CP, Blazing MA et al. IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial) Investigators. Benefit of Adding Ezetimibe to Statin Therapy on Cardiovascular Outcomes and Safety in Patients With Versus Without Diabetes Mellitus: Results From IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial). Circulation 2018; 137(15): 1571–1582. Dostupné z DOI: <https://doi: 10.1161/CIRCULATIONAHA.117.030950>.
Dujovne CA, Ettinger MP, McNeer JF et al. Ezetimibe Study Group. Efficacy and safety of a potent new selective cholesterol absorption inhibitor, ezetimibe, in patients with primary hypercholesterolemia. Am J Cardiol 2002; 90(10): 1092–1097. Dostupné z DOI: <https://doi: 10.1016/s0002–9149(02)02798–4>.
Tůmová E, Vrablík M. Kyselina bempedoová v kontextu současných možností hypolipidemické léčby a výsledků studie CLEAR OUTCOMES. AtheroRev 2023; 8(2): 85–94.
Pella D. Význam nestatínových liekov pre znižovanie LDL-cholesterolu v manažmente veľmi vysokého a vysokého aterosklerotického kardiovaskulárního rizika. AtheroRev 2023; 8(2): 77–83.
Nissen SE, Menon V, Nicholls SJ et al. Bempedoic Acid for Primary Prevention of Cardiovascular Events in Statin-Intolerant Patients. JAMA 2023; 330(2): 131–140. Dostupné z DOI: <https://doi: 10.1001/jama.2023.9696>.
Altschmiedová T, Todorovová V, Šnejdrlová M et al. PCSK9 Inhibitors in Real-world Practice: Analysis of Data from 314 Patients and 2 Years of Experience in a Center of Preventive Cardiology. Curr Atheroscler Rep 2022; 24(5): 357–363. Dostupné z DOI: <https://doi: 10.1007/s11883–022–01008–8>.
Karásek D. Inklisiran – nový reprezentant biologické léčby dyslipidemie. Klin Farmakol Farm 2023; 37(3): 112–114.
Češka R, Vrablík M, Štulc T. Fibráty v roce 2018 – příběh pokračuje. AtheroRev 2018; 3(3): 161–168.
Agnello F, Finocchiaro S, Laudani C et al. A review of polypills for the prevention of atherosclerotic cardiovascular disease. Am Heart J 2023; 266: 74–85. Dostupné z DOI: <https://doi: 10.1016/j.ahj.2023.08.012>.
Reiner Z. Resistance and intolerance to statins. Nutr Metab Cardiovasc Dis 2014; 24(10): 1057–1066. Dostupné z DOI: <https://doi: 10.1016/j.numecd.2014.05.009>.
Štítky
Angiology Diabetology Internal medicine Cardiology General practitioner for adultsČlánok vyšiel v časopise
Athero Review
2024 Číslo 1
- Memantine Eases Daily Life for Patients and Caregivers
- Metamizole at a Glance and in Practice – Effective Non-Opioid Analgesic for All Ages
- Metamizole vs. Tramadol in Postoperative Analgesia
- Advances in the Treatment of Myasthenia Gravis on the Horizon
- Spasmolytic Effect of Metamizole
Najčítanejšie v tomto čísle
- I am 55 years old, my cholesterol is 6.5 mmol/l and I do not want statin
- Consensus statement of the European Atherosclerosis Society on the 2022 lipoprotein(a) – responses to the frequently asked questions about these recommendations
- First clinical experience with inclisiran in Slovakia – experience with administration, management and efficacy from one center
- PCSK9 inhibitors (temporarily) in the broad practice of outpatient specialists: short but positive experience