title: A review of the evidence on reducing macrovascular risk in patients with atherogenic dyslipidaemia: A report from an expert consensus meeting on the role of fenofibrate-statin combination therapy.
abstract: A meeting of European experts in cardiovascular (CV) disease and lipids was convened in Paris, France, on 10 November 2014 to discuss lipid profile, and in particular atherogenic dyslipidaemia (AD), and associated CV risk. Key points that were raised and discussed during the meeting are summarised in this paper, which also accounts for further discussion and agreement on these points by the group of experts. Elevated levels of low-density lipoprotein cholesterol (LDL-c) are commonly associated with a greater CV risk than low LDL-c levels, and are routinely managed with statins. However, even for patients controlled on statins and achieving low LDL-c levels, abnormal lipid profiles observed in some patients (i.e. elevated triglyceride levels, with/without low levels of high-density lipoprotein cholesterol [HDL-c]) have been linked to the presence of a residual CV risk. Therefore, it is recommended that both triglyceride and HDL-c levels be measured, to allow for the overall CV residual risk to be adequately managed. Favourable safety and clinical data support the combination of statins with other lipid-lowering agents, such as fenofibrate. Patients who have elevated triglyceride levels plus low levels of HDL-c are most likely to achieve clinical benefit from fenofibrate-statin combination therapy. In these patients with AD, achieving target non-HDL-c levels should be a key focus of CV risk management, and the use of non-HDL-c was advocated to provide a better measure of CV risk than LDL-c levels.
authors: Hospital Santa Cruz, Centro Hospitalar de Lisboa Ocidental, EPE, Carnaxide, Portugal.
authors: Carlos
authors: C
authors: Aguiar
authors: Cardiology Department, Policlínica Gipuzkoa, San Sebastián, Spain.
authors: Eduardo
authors: E
authors: Alegria
authors: Division of Endocrinology, Department of Clinical and Experimental Medicine, University of Parma and Azienda Ospedaliera Universitaria of Parma, Italy.
authors: Riccardo C
authors: RC
authors: Bonadonna
authors: Department of Pharmacological and Biomolecular Sciences, University of Milan, IRCCS Multimedica, Milan, Italy. Electronic address: alberico.catapano@unimi.it.
authors: Alberico L
authors: AL
authors: Catapano
authors: Cardiology Unit, Department of Medicine, Karolinska University Hospital, Stockholm, Sweden.
authors: Francesco
authors: F
authors: Cosentino
authors: Department of Internal Medicine, University of Ioannina Medical School, Greece.
authors: Moses
authors: M
authors: Elisaf
authors: Point Médical, Dijon, France.
authors: Michel
authors: M
authors: Farnier
authors: Department of Cardiology, Toulouse University School of Medicine, Rangueil Hospital, Toulouse, France.
authors: Jean
authors: J
authors: Ferrières
authors: Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy.
authors: Pasquale Perrone
authors: PP
authors: Filardi
authors: Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors: Nicolae
authors: N
authors: Hancu
authors: Department of Cardiology, Ege University Medical School, İzmir, Turkey.
authors: Meral
authors: M
authors: Kayikcioglu
authors: Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal.
authors: Alberto
authors: A
authors: Mello E Silva
authors: Hospital General Universitario Gregorio Marañón, Facultad de Medicina de la Universidad Complutense, Madrid, Spain.
authors: Jesus
authors: J
authors: Millan
authors: University Hospital Center, School of Medicine, University of Zagreb, Croatia.
authors: Željko
authors: Ž
authors: Reiner
authors: Hacettepe University, Ankara, Turkey.
authors: Lale
authors: L
authors: Tokgozoglu
authors: Department of Endocrinology Diabetology Nutrition, Jean Verdier Hospital, APHP, Paris Nord University, CRNH-IdF, CINFO, Bondy, France.
authors: Paul
authors: P
authors: Valensi
authors: North Estonia Medical Centre, Tallinn University of Technology, Estonia.
authors: Margus
authors: M
authors: Viigimaa
authors: 3rd Department of Internal Medicine, 1st Medical Faculty, Charles University, Prague, Czech Republic.
authors: Michal
authors: M
authors: Vrablik
authors: Clinica Medica, Department of Medicine, University of Padova, Italy.
authors: Alberto
authors: A
authors: Zambon
authors: University Alcalá de Henares, Hospital Ramón y Cajal, Madrid, Spain.
authors: José Luis
authors: JL
authors: Zamorano
authors: Department of Cardiology and LTTA Centre, University Hospital of Ferrara and Maria Cecilia Hospital, GVM Care & Research, E.S: Health Science Foundation, Cotignola, Italy.
authors: Roberto
authors: R
authors: Ferrari
mesh_terms: D050197:Atherosclerosis / Q000188:drug therapy*; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy; D004359:Drug Therapy, Combination; D050171:Dyslipidemias / Q000188:drug therapy*; D005060:Europe; D011345:Fenofibrate / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood; D010297:Paris
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D008055:Lipids; D011345:Fenofibrate
keywords: Atherogenic dyslipidaemia; cardiovascular risk; cholesterol; combination therapy; fenofibrate; statins; triglycerides