Articles producció científica> Medicina i Cirurgia

Combination therapy in the guidelines: from high-intensity statins to high-intensity lipid-lowering therapies

  • Identification data

    Identifier: imarina:9280414
    Authors:
    Masana, LuisIbarretxe, DaianaAndreychuk, NataliaRoyuela, MeritxellRodríguez-Borjabad, CeliaPlana, Nuria
    Abstract:
    The causal role of cholesterol in atherosclerosis was established more than 100 years ago. Along with the fact that the higher the cholesterol, the greater the risk of atherosclerotic cardiovascular diseases (ASCVD), many randomized controlled trials (RCT) have shown that lowering LDL cholesterol (LDL-C) is associated with a lower incidence of ASCVD. This impact of lipid-lowering therapies on cardiovascular risk is independent of the drug used, as shown by several meta-analyses and Mendelian randomization studies. Therefore, the concept of using “high-intensity statins” should be changed to “high-intensity lipid-lowering therapies” that go beyond the use of statins. Recent RCTs using non-statin lipid-lowering therapies has provided scientific evidence that the lower the LDL-C, the better in terms of cardiovascular events. Based on these observations, current guidelines recommend achieving very low LDL-C levels in patients with high and very-high cardiovascular risk. To achieve these demanding goals, the physician must use the full spectrum of lipid-lowering therapies, beyond high-intensity, high-dose statins. Oral combination therapies and, when necessary, subcutaneous treatments become the new standard of care for hypercholesterolemia. However, the number of patients achieving LDL-C goals is unacceptably low. This is due in part to insufficient prescription and insufficient treatment. To improve the efficacy of therapy, several strategies have been proposed, step by step, planning therapy and maximizing treatment, based on the needs of the patient. A wider use of lipid-lowering
  • Others:

    Author, as appears in the article.: Masana, Luis; Ibarretxe, Daiana; Andreychuk, Natalia; Royuela, Meritxell; Rodríguez-Borjabad, Celia; Plana, Nuria
    Department: Medicina i Cirurgia
    URV's Author/s: Masana Marín, Luis
    Abstract: The causal role of cholesterol in atherosclerosis was established more than 100 years ago. Along with the fact that the higher the cholesterol, the greater the risk of atherosclerotic cardiovascular diseases (ASCVD), many randomized controlled trials (RCT) have shown that lowering LDL cholesterol (LDL-C) is associated with a lower incidence of ASCVD. This impact of lipid-lowering therapies on cardiovascular risk is independent of the drug used, as shown by several meta-analyses and Mendelian randomization studies. Therefore, the concept of using “high-intensity statins” should be changed to “high-intensity lipid-lowering therapies” that go beyond the use of statins. Recent RCTs using non-statin lipid-lowering therapies has provided scientific evidence that the lower the LDL-C, the better in terms of cardiovascular events. Based on these observations, current guidelines recommend achieving very low LDL-C levels in patients with high and very-high cardiovascular risk. To achieve these demanding goals, the physician must use the full spectrum of lipid-lowering therapies, beyond high-intensity, high-dose statins. Oral combination therapies and, when necessary, subcutaneous treatments become the new standard of care for hypercholesterolemia. However, the number of patients achieving LDL-C goals is unacceptably low. This is due in part to insufficient prescription and insufficient treatment. To improve the efficacy of therapy, several strategies have been proposed, step by step, planning therapy and maximizing treatment, based on the needs of the patient. A wider use of lipid-lowering
    licence for use: https://creativecommons.org/licenses/by/3.0/es/
    Author's mail: luis.masana@urv.cat
    Author identifier: 0000-0002-0789-4954
    Record's date: 2023-11-18
    Papper version: info:eu-repo/semantics/publishedVersion
    Link to the original source: https://eathj.org/index.php/eaj/article/view/10/7
    Papper original source: European Atherosclerosis Journal. 1 (1): 25-29
    APA: Masana, Luis; Ibarretxe, Daiana; Andreychuk, Natalia; Royuela, Meritxell; Rodríguez-Borjabad, Celia; Plana, Nuria (2022). Combination therapy in the guidelines: from high-intensity statins to high-intensity lipid-lowering therapies. European Atherosclerosis Journal, 1(1), 25-29. DOI: 10.56095/eaj.v1i1.10
    Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
    Article's DOI: 10.56095/eaj.v1i1.10
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2022
    Publication Type: Journal Publications