Statins plus ezetimibe in the era of proprotein convertase subtilisin/kexin type-9 inhibitors.

Statins plus ezetimibe in the era of proprotein convertase subtilisin/kexin type-9 inhibitors. Kardiol Pol. 2020 Jul 24;: Authors: De Luca L, Corsini A, Uguccioni M, Colivicchi F Abstract Statins are first-line agents in patients with dyslipidemia, with established benefits for reducing low-density-lipoprotein cholesterol (LDL-C) levels and cardiovascular events. However, a considerable number of statin-treated patients do not achieve target LDL-C levels, even at maximally tolerated statin doses, or are intolerant to intensive statin therapy. These patients can benefit from the addition of a non-statin lipid-lowering agent, and recent cholesterol guidelines have placed increased focus on combination lipid-lowering therapy. For patients that cannot achieve target treatment goals with statin therapy alone, the addition of the cholesterol absorption inhibitor ezetimibe leads to additional LDL-C reductions with good tolerability, and reductions in cardiovascular morbidity and mortality. The more recent Proprotein Convertase Subtilisin-Like/Kexin Type 9 (PCSK-9) inhibitors can lower LDL-C by an additional 45-65% and are also well tolerated with associated cardiovascular outcome data. These complementary approaches for LDL-C lowering in statin-treated patients lower LDL-C levels beyond that achieved with statin monotherapy. As no threshold level has been established below which LDL-C lowering benefits cease to occur, an early combination t...
Source: Polish Heart Journal - Category: Cardiology Authors: Tags: Kardiol Pol Source Type: research