Therapy for Hyperlipidemia

Area of Science:

• Cardiology
• Preventive Medicine
• Pharmacology

Background:

• Atherosclerotic cardiovascular disease (ASCVD) remains a leading cause of mortality globally.
• Risk stratification and treatment strategies have evolved significantly over the past decade.
• Current guidelines emphasize personalized risk assessment and tailored therapeutic interventions.

Purpose of the Study:

• To review recent advancements in ASCVD risk stratification and treatment.
• To highlight the role of lipid panels and coronary artery calcium (CAC) imaging in risk estimation.
• To discuss the current evidence for pharmacologic interventions in ASCVD risk reduction.

Main Methods:

• Review of recent clinical guidelines and landmark cardiovascular outcomes trials.
• Analysis of data regarding the efficacy and safety of lipid-lowering agents.
• Evaluation of the utility of CAC scoring in clinical practice.

Main Results:

• Lipid panels are foundational, with CAC imaging increasingly utilized for individual risk assessment.
• Statins are first-line therapy; ezetimibe, PCSK9 inhibitors, and bempedoic acid offer additional risk reduction in high-risk individuals.
• Triglyceride-lowering medications lack proven ASCVD risk reduction, except for icosapent ethyl in specific populations.

Conclusions:

• Personalized ASCVD risk assessment integrates traditional markers with advanced imaging.
• A multi-drug approach, guided by risk assessment, is crucial for optimal cardiovascular risk reduction.
• Therapeutic decisions should be evidence-based, considering the specific role of each agent in reducing cardiovascular events.