Individualized lipid-lowering therapy to further reduce residual cardiovascular risk. Issue 169 (May 2017)

• Record Type: Journal Article
• Authors: Weingärtner, Oliver; Lütjohann, Dieter; Plösch, Torsten; Elsässer, Albrecht
• Is Part Of: Journal of steroid biochemistry and molecular biology. Issue 169(2017)
• Page Start: 198
• Page End: 201
• Publication Date: 2017-05
• Subjects: Cholesterol -- Individualized lipid-lowering therapy -- Cardiovascular risk; Steroid hormones -- Periodicals; Biochemistry -- Periodicals; Hormones -- Periodicals; Molecular Biology -- Periodicals; Hormones stéroïdes -- Périodiques; Steroid hormones; Periodicals; 572.579
• DOI: 10.1016/j.jsbmb.2016.05.016
• Languages: English
• ISSNs: 0960-0760

Abstract

Highlights: Optimal lipid-lowering therapy is essential for patients with known cardiovascular diseases. This review summarizes current endpoint studies of lipid-lowering drugs and suggests an individual approach based on patient characteristics. The "Oldenburg Lipid Therapy Path" is a suggestion for a model to guide the use of combined lipid-lowering therapy. Abstract: Hypercholesterolemia is a major risk factor for cardiovascular diseases. Serum cholesterol concentrations are regulated by enteral absorption, biliary secretion, and hepatic synthesis. Statins inhibit the rate-limiting enzyme of cholesterol synthesis, HMG-CoA-reductase, and reduce serum cholesterol concentrations as well as cardiovascular morbidity and mortality. Some studies indicate that patients with high baseline cholesterol absorption may show only a small response to statin treatment in terms of cholesterol lowering. Data from genetic association studies and from the IMPROVE-IT trial show that reducing intestinal cholesterol absorption via NCP1L1 further reduces cardiovascular risk. However, some patients do not attain LDL-cholesterol targets on combination therapy. For these patients PCSK9-antibody treatment and lipid-apheresis are options to be considered. This article reviews the current literature on this issue and suggests 'individualized lipid-lowering therapy' as an approach to optimize and personalize lipid-lowering treatment of patients with hypercholesterolemia to further reduce residual cardiovascular risk.