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Triglycerides and atherogenic dyslipidaemia: extending treatment beyond statins in the high-risk cardiovascular

Gerald F Watts1, Fredrik Karpe

  • 1School of Medicine and Pharmacology, University of Western Australia, Perth, WA 6847, Western Australia. gerald.watts@uwa.edu.au

Heart (British Cardiac Society)
|February 8, 2011
PubMed

Insights

Statins reduce cardiovascular disease (CVD) risk, but residual risk persists due to uncorrected atherogenic dyslipidaemia. Adding fenofibrate to statins shows promise for improving lipid profiles and outcomes in high-risk patients.

Area of Science:

  • Cardiology
  • Metabolic Disorders
  • Pharmacology

Background:

  • Cardiovascular disease (CVD) risk remains high despite statin therapy.
  • Atherogenic dyslipidaemia, driven by hypertriglyceridaemia, contributes to residual CVD risk.
  • Hypertriglyceridaemia is common in type 2 diabetes and metabolic syndrome.

Purpose of the Study:

  • To evaluate strategies for correcting persistent atherogenic dyslipidaemia in patients on statin therapy.
  • To review clinical trial evidence for agents like niacin, fibrates, and n-3 fatty acids in managing residual CVD risk.

Main Methods:

  • Review of clinical trial evidence for add-on therapies to statins.
  • Analysis of data on fenofibrate, niacin, and n-3 fatty acids in dyslipidaemic patients.
  • Focus on outcomes in patients with type 2 diabetes and metabolic syndrome.

Main Results:

  • New data support adding fenofibrate to statin therapy.
  • Fenofibrates demonstrate specific benefits in dyslipidaemic patients and improve diabetic retinopathy.
  • Ongoing trials may provide evidence for niacin as an add-on therapy.
  • Low-dose n-3 fatty acids may be beneficial post-myocardial infarction, but higher doses require further evidence.

Conclusions:

  • Fenofibrate is a viable option to add to statins for managing residual CVD risk.
  • Niacin and n-3 fatty acids may also play roles, with ongoing research.
  • Addressing atherogenic dyslipidaemia is crucial for reducing residual CVD risk.

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