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Management of dyslipidaemia in patients with comorbidities-facing the challenge

Lisa Frühwald1,2, Peter Fasching1,2, Dobromir Dobrev3,4,5

  • 15th Medical Department with Endocrinology, Rheumatology and Acute-Geriatrics, Vienna Health Association, Ottakring Clinic, Montleartstraße 37, 1160 Vienna, Austria.

European Heart Journal. Cardiovascular Pharmacotherapy
|December 24, 2024
PubMed

Insights

This review explores the benefits and risks of lipid-lowering drugs for patients with liver disease. It highlights the need for more research to guide treatment for those with both liver and cardiovascular conditions.

Area of Science:

  • Cardiology
  • Hepatology
  • Pharmacology

Background:

  • Elevated liver enzymes often lead to discontinuation of lipid-lowering drugs.
  • This can prevent patients from receiving cardiovascular benefits.
  • There is limited real-world evidence on these drugs in patients with liver disease.

Purpose of the Study:

  • To review the evidence on benefits and risks of lipid-lowering drugs in patients with liver disease.
  • To focus on potential liver-related side effects of these medications.
  • To provide guidance for treating patients with liver dysfunction.

Main Methods:

  • Literature search of PubMed.
  • Examination of efficacy and safety profiles of various lipid-lowering agents.
  • Focus on statins, ezetimibe, bempedoic acid, PCSK9 inhibitors, fibrates, and icosapent ethyl.

Main Results:

  • Assessing drug-induced hepatotoxicity is challenging due to reliance on case reports.
  • Robust evidence for lipid-lowering therapy in pre-existing liver disease is lacking.
  • Available data on lipid-lowering drugs and liver health were summarized.

Conclusions:

  • Further research is needed to optimize treatment strategies.
  • Patients with coexisting liver and cardiovascular disease require tailored approaches.
  • Balancing cardiovascular protection and liver safety is crucial.

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