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    Strategies for the use of nonstatin therapies

    257897.pdf (709.4Kb)
    Access Status
    Open access
    Authors
    Pirillo, A.
    Norata, Giuseppe
    Catapano, A.
    Date
    2017
    Type
    Journal Article
    
    Metadata
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    Citation
    Pirillo, A. and Norata, G. and Catapano, A. 2017. Strategies for the use of nonstatin therapies. Current Opinion in Lipidology. 28 (6): pp. 458-464.
    Source Title
    Current Opinion in Lipidology
    DOI
    10.1097/MOL.0000000000000459
    ISSN
    0957-9672
    School
    School of Biomedical Sciences
    URI
    http://hdl.handle.net/20.500.11937/59226
    Collection
    • Curtin Research Publications
    Abstract

    Purpose of review: Dyslipidaemias are a major risk factor for cardiovascular disease (CVD); in particular, high levels of low-density lipoprotein cholesterol (LDL-C) have been associated to a higher cardiovascular risk. Reducing LDL-C levels decreases the risk of coronary heart disease (CHD), and the greater the LDL-C reduction, the greater the decrease in cardiovascular risk. Although statins represent the first line lipid-lowering therapy, many patients do not reach the recommended goals or exhibit adverse side effects leading to therapy discontinuation; in addition, a significant percentage of statin-treated patients continue to experience cardiovascular events even in the presence of well controlled LDL-C levels, because of alterations in other lipid/lipoprotein classes, including triglycerides and high-density lipoprotein cholesterol. Recent findings: These conditions require further therapeutic interventions to achieve the recommended lipid goals. Several drugs have been developed to address these needs. Recent studies have shown that the association of ezetimibe with rosuvastatin or atorvastatin results in a better hypolipidaemic effect; in addition to this, PCSK9 inhibitors significantly reduce LDL-C levels and cardiovascular events. Summary: For patients who are intolerant to statins or not able to reach the recommended LDL-C levels, despite maximal tolerated dose of statin, or exhibiting additional lipid alterations, several drugs are available that can be used either in monotherapy or on top of the maximally tolerated dose of statins.

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