Dyslipidemia - the known unknown

Area of Science:

• Cardiology
• Endocrinology
• Metabolic Diseases

Background:

• Dyslipidemia (DLP) is a primary risk factor for atherosclerotic cardiovascular disease (ASCVD) and acute pancreatitis, particularly with severe hypertriglyceridemia.
• High prevalence of DLP contrasts with inadequate control, especially in high-risk populations.
• Secondary causes of DLP must be excluded during diagnosis.

Purpose of the Study:

• To outline current strategies for managing dyslipidemia (DLP).
• To emphasize risk stratification and individualized lipid target setting for ASCVD prevention.
• To introduce novel therapeutic options for dyslipidemia management.

Main Methods:

• Assessment of overall cardiovascular (CV) risk using SCORE2/SCORE2-OP or individual comorbidities.
• Implementation of dietary and lifestyle modifications as first-line treatment.
• Pharmacological interventions including statins, ezetimibe, PCSK9 inhibitors (inclisiran), and specific agents for severe hypertriglyceridemia (fibrates, lomitapide, volanesorsen, evinacumab).

Main Results:

• Target lipid values, particularly LDL-cholesterol, are determined by CV risk category.
• Inclisiran, a novel siRNA targeting PCSK9, offers improved adherence when administered in outpatient clinics.
• For severe hypertriglyceridemia, fibrates are a primary option, with other specialized therapies available under strict criteria.

Conclusions:

• Effective dyslipidemia management is crucial for preventing ASCVD and pancreatitis.
• A multi-faceted approach combining lifestyle changes, risk assessment, and tailored pharmacotherapy is essential.
• Newer agents like inclisiran represent advancements in DLP treatment, improving patient adherence and outcomes.