Current Atherosclerosis Reports, Journal Year: 2024, Volume and Issue: 27(1)
Published: Nov. 25, 2024
Language: Английский
Archives of Medical Science, Journal Year: 2022, Volume and Issue: unknown
Published: Oct. 28, 2022
1. Sabouret P, Angoulvant D, Cannon CP, Banach M. Low levels of low-density lipoprotein cholesterol, intracerebral haemorrhage, and other safety issues: is there still a matter debate?Eur Heart J Open2022; 2: oeac038. Google Scholar
Language: Английский
Citations
44
Archives of Medical Science, Journal Year: 2023, Volume and Issue: unknown
Published: Nov. 1, 2023
In 2023 there are still even 75% of patients over the target low-density lipoprotein cholesterol (LDL-C), and hypercholesterolemia is most common worst monitored cardiovascular risk factor. How it possible, considering knowledge we have on role in process atherosclerosis, atherosclerotic disease (ASCVD) its complications, methods lipid disorders diagnosis, prevention, treatment. Nowadays, almost 4 million deaths per year attributed to LDL-C, 2/3 all CVD ASCVD, therefore hypothetically should easily prevent few several with early intensive non-pharmacological pharmacological therapies. Moreover, lipidology now, besides oncology, area highest number new ongoing trials effective safe medications that already appeared will soon be available. Therefore, no doubt called prospective lowering therapies (LLTs). this State-of-the-Art paper summarized important trials, studies, recommendations LLTs, suitable graphical summaries might helpful for physicians their practice a look nearest future being under investigation. Let's hope those helps render dyslipidemia rare next years.
Language: Английский
Citations
31
European Journal of Preventive Cardiology, Journal Year: 2024, Volume and Issue: 31(15), P. 1792 - 1803
Published: June 11, 2024
Abstract Aims To assess whether implementation of the 2019 European Society Cardiology (ESC)/European Atherosclerosis (EAS) dyslipidaemia guidelines observed between 2020 and 2021 improved 2022 in SANTORINI study. Methods results Patients with high or very cardiovascular (CV) risk were recruited across 14 countries from March to February 2021, 1-year prospective follow-up until May 2022. Lipid-lowering therapy (LLT) ESC/EAS risk-based low-density lipoprotein (LDL) cholesterol (LDL-C) goal attainment (defined as <1.4 mmol/L for patients at CV <1.8 risk) compared baseline. Of 9559 enrolled, 9136 (2626 6504 had any available data, 7210 (2033 5173 baseline LDL-C data. was escalated one-third unchanged two-thirds. Monotherapy combination usage rose 53.6 25.6% 57.1 37.9%, respectively. Mean levels decreased 2.4 2.0 mmol/L. Goal 21.2 30.9%, largely driven by LLT use among those not on greater monotherapy (39.4 vs. 25.5%). Conclusion achievement lipid goals increased over particularly when used. Nonetheless, most remained above goal; hence, strategies are needed improve LLT.
Language: Английский
Citations
12
Drugs, Journal Year: 2024, Volume and Issue: unknown
Published: Nov. 4, 2024
Atherosclerotic cardiovascular disease (ASCVD) and consequent acute coronary syndromes (ACS) are substantial contributors to morbidity mortality across Europe. Fortunately, as much two thirds of this disease's burden is modifiable, in particular by lipid-lowering therapy (LLT). Current guidelines based on the sound premise that, with respect low-density lipoprotein cholesterol (LDL-C), "lower better for longer", recent data have strongly emphasised need also "the earlier better". In addition statins, which been available several decades, ezetimibe, bempedoic acid (also fixed dose combinations), modulators proprotein convertase subtilisin/kexin type 9 (PCSK9 inhibitors inclisiran) additionally very effective approaches LLT, especially those at high extremely risk. real life, however, clinical practice goals still not met a proportion patients (even 70%). However, options we available, should render lipid disorders rare disease. April 2021, International Lipid Expert Panel (ILEP) published its first position paper optimal use LLT post-ACS patients, complemented existing management lipids following ACS, defined group "extremely high-risk" individuals outlined scenarios where upfront combination be considered improve access adherence and, consequently, therapy's effectiveness. These updated recommendations build previous work, considering developments evidential underpinning ongoing education role disorder therapy, changes availability drugs. Our aim provide guide address unmet need, clear practical advice, whilst acknowledging patient-centred care, accounting often large differences LLTs between countries.
Language: Английский
Citations
9
Journal of the American College of Cardiology, Journal Year: 2025, Volume and Issue: 85(15), P. 1550 - 1564
Published: April 1, 2025
Combination lipid-lowering therapy (LLT) after myocardial infarction (MI) achieves lower low-density lipoprotein cholesterol (LDL-C) levels and better cardiovascular outcomes vs statin monotherapy. As a result, global guidelines recommend LDL-C but, paradoxically, advise treatment through stepwise approach. Yet the need for combination is inevitable as <20% of patients achieve goals with statins alone. Whether combining ezetimibe early late MI results in unknown. In this study, authors sought to assess impact delayed escalation on by comparing oral LLT (statins plus ezetimibe) MI. LLT-naïve (SWEDEHEART registry) hospitalized (2015-2022) discharged were included. Using clone-censor-weight Cox proportional hazards models, we compared differences risks MACE (death, MI, stroke), components MACE, death between added ≤12 weeks discharge reference (early therapy), from 13 16 months (late or not at all. Of 35,826 (median age 65.1 years, 26.0% women), 6,040 (16.9%) received early, 6,495 (18.1%) late, 23,291 (65.0%) no ezetimibe. High-intensity use was ≥98% all groups. Over median 3.96 years (Q1-Q3: 2.15-5.81 years), 2,570 had (440 deaths). One-year incidences 1.79 (early), 2.58 (late), 4.03 (none) per 100 patient-years. Compared therapy, weighted risk 1, 2, 3 0.6% (95% CI: 0.1%-1.1%; P < 0.01), 1.1% 0.3%-2.0%; 0.7% -0.2% 1.3%; = 0.18), 3-year HR 1.14 0.95-1.41). For those receiving ezetimibe, 0.2%-1.3%), 1.6% 0.8%-2.5%), 1.9% 0.8%-3.1%; <0.01; HR: 1.29 [95% 1.12-1.55]). Similar observed (HRs early: late: 1.64 1.15-2.63]; none: 1.83 1.35-2.69]). care pathways should implement standard care, because delaying using high-intensity monotherapy associated avoidable harm.
Language: Английский
Citations
1
Current Atherosclerosis Reports, Journal Year: 2024, Volume and Issue: unknown
Published: Jan. 2, 2024
Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of premature death. Lipid disorders, particularly elevated serum low-density lipoprotein cholesterol (LDL-C), contribute significantly to ASCVD. The risk developing ASCVD influenced by the duration exposure LDL-C concentrations (cholesterol-years concept). Implementing lipid-lowering treatments based on principles "the earlier better," lower and longer better" has been shown reduce extend lifespan. Despite availability numerous drugs, achieving satisfactory control lipid disorders remains very challenging. Therefore, there need for novel approaches improve treatment adherence.
Language: Английский
Citations
6
Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(7), P. 1882 - 1882
Published: March 25, 2024
Cardiovascular diseases (CVDs) are a leading global cause of mortality and primarily driven by atherosclerotic coronary artery disease. Their pathogenesis involves multi-factorial mechanisms, among which low-density lipoprotein (LDL) plays causative role. Recent ESC/EAS guidelines advocate for shift toward new risk estimation algorithms that better emphasize non-fatal cardiovascular events, lifetime prediction, tailored pharmacological approaches, including statin + ezetimibe triple therapy, in specific cases. Intensive lipid-lowering therapy has been shown to be pivotal, especially post-acute events. Intracoronary imaging revealed insights into the composition plaque demonstrated significant regression can achieved through use statins such as rosuvastatin atorvastatin. The positive effects Proprotein Convertase Subtilisin/Kexin type 9 (PCSK9) inhibitors, particularly alirocumab evolocumab, on regression, have demonstrated. Inclisiran, targets PCSK9 gene expression, significantly reduces LDL cholesterol. associated challenges include hesitancy prescribe intensive regimens limited treatment adherence, highlighting need combinations improve therapeutic outcomes.
Language: Английский
Citations
4
Pharmacological Research, Journal Year: 2024, Volume and Issue: 205, P. 107246 - 107246
Published: June 5, 2024
Language: Английский
Citations
4
Mayo Clinic Proceedings, Journal Year: 2025, Volume and Issue: unknown
Published: March 1, 2025
Language: Английский
Citations
0
Baylor University Medical Center Proceedings, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 10
Published: April 25, 2025
Language: Английский
Citations
0