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09:15
Differential Effects of Lipid-lowering Drugs in Modulating Morphology of Cholesterol Particles
Published on: November 10, 2017
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Evolving concepts on the management of dyslipidaemia
Olivier S Descamps1, Ann Verhaegen2, Fabien Demeure3
1Department of internal medicine, Centres Hospitaliers Jolimont, Haine Saint-Paul and department of cardiology, UCL Cliniques Universitaires Saint-Luc, Bruxelles, Belgium.
Acta Clinica Belgica
|December 18, 2019
Summary
Lowering low-density lipoprotein cholesterol (LDL-C) as much as possible is key to preventing atherosclerotic cardiovascular disease (ASCVD). New guidelines emphasize maximizing LDL-C reduction, even to very low levels, which appears safe and beneficial for high-risk patients.
Area of Science:
- Cardiology
- Lipidology
- Preventive Medicine
Background:
- Low-density lipoproteins (LDL) are causally linked to atherosclerotic cardiovascular disease (ASCVD).
- Lowering LDL cholesterol (LDL-C) demonstrably reduces ASCVD risk.
- No safe LDL-C threshold exists below which ASCVD prevention benefits plateau.
Purpose of the Study:
- To review recent advancements in lipidology over the past decade.
- To describe key updates in the 2019 European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) guidelines.
- To highlight the shift towards a benefit-based strategy in ASCVD prevention.
Main Methods:
- Review of current literature and recent concepts in lipidology.
- Analysis of the 2019 ESC/EAS guidelines for ASCVD prevention.
- Focus on the clinical benefits of treating the underlying causes of ASCVD.
Main Results:
- Maximum LDL-C reduction is recommended for ASCVD prevention, especially in high-risk individuals.
- Very low LDL-C levels are considered safe and offer further preventive benefits.
- Combination therapies (statins, ezetimibe, PCSK9 inhibitors) are increasingly important for high-risk patients.
Conclusions:
- The 2019 ESC/EAS guidelines advocate for aggressive LDL-C lowering to prevent ASCVD.
- A strategy focused on maximizing clinical benefit by treating lipid-related causes of ASCVD is emphasized.
- Combination therapies are crucial for achieving optimal LDL-C reduction in high-risk populations.
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