Rationale for targeting multiple lipid pathways for optimal cardiovascular risk reduction.
Clinical trials of statin therapy have consistently demonstrated significant reductions in coronary artery disease (CAD) events, yet statin-treated patients remain at risk for CAD despite substantial reductions in low-density lipoprotein (LDL) cholesterol. Recent evidence from clinical trials supports reduction of LDL cholesterol to lower targets, and the updated treatment guidelines include optional, more aggressive LDL cholesterol goals for patients at very high and moderately high risk. Achievement of these lower goals will require enhanced treatment strategies. Targeting multiple lipid pathways can provide greater reductions in LDL cholesterol as well as improvements in other lipid parameters. Clinical trials are needed to determine which treatment strategies provide optimal cardiovascular risk reduction.
Ballantyne
Christie M
CM
Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart Center, Houston, Texas, USA. cmb@bcm.tmc.edu
D000368:Aged; D000924:Anticholesteremic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001384:Azetidines / Q000008:administration & dosage / Q000627:therapeutic use*; D008078:Cholesterol, LDL / Q000097:blood*; D003327:Coronary Disease / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D004359:Drug Therapy, Combination; D050171:Dyslipidemias / Q000150:complications / Q000188:drug therapy; D000069438:Ezetimibe; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D006973:Hypertension / Q000150:complications; D012307:Risk Factors
D000924:Anticholesteremic Agents; D001384:Azetidines; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000069438:Ezetimibe