Low-density lipoprotein cholesterol lowering treatment: the current approach

Area of Science:

• Cardiology
• Pharmacology

Background:

• Elevated low-density lipoprotein cholesterol (LDLc) is a key factor in atherosclerosis development and progression.
• Statins revolutionized cardiovascular disease prevention by effectively lowering LDLc.
• Other lipid-lowering agents like ezetimibe, bile acid sequestrants, and PCSK9 inhibitors offer alternative or adjunctive therapies.

Purpose of the Study:

• To review the 2019 European Atherosclerosis Society/European Society of Cardiology guidelines for dyslipidemia management.
• To focus on available and emerging LDLc-lowering drugs.
• To provide guidance on patient selection, timing, and methods for LDLc reduction in clinical practice.

Main Methods:

• Narrative review of current literature and clinical guidelines.
• Focus on pharmacological interventions for LDLc reduction.
• Discussion of treatment strategies based on the latest European guidelines.

Main Results:

• Statins are the primary therapy for LDLc reduction.
• Combination therapy and alternative agents are used for statin-intolerant patients or when additional LDLc lowering is needed.
• PCSK9 inhibitors are approved for hypercholesterolemia and secondary cardiovascular prevention.

Conclusions:

• The management of dyslipidemia requires a strategic approach to LDLc reduction.
• Understanding the role and application of various lipid-lowering drugs is essential for optimal patient care.
• Adherence to updated clinical guidelines ensures effective treatment for cardiovascular risk reduction.