Reasons Why Combination Therapy Should Be the New Standard of Care to Achieve the LDL-Cholesterol Targets: Lipid-lowering combination therapy

被引：39

作者：

Masana, Lluis ^{[1
,2
]}

Ibarretxe, Daiana ^{[1
,2
]}

Plana, Nuria ^{[1
,2
]}

机构：

[1] Univ Rovira & Virgili, St Joan Univ Hosp, Vasc Med & Metab Unit, Res Unit Lipids & Atherosclerosis,IISPV, C St Llorenc 21, Reus 43201, Spain

[2] Spanish Biomed Res Ctr Diabet & Associated Metab, Madrid, Spain

来源：

CURRENT CARDIOLOGY REPORTS | 2020年 / 22卷 / 08期

关键词：

Lipid-lowering combination therapy; Statins; Ezetimibe; PCSK9; inhibitors; Cardiovascular prevention; DENSITY-LIPOPROTEIN CHOLESTEROL; VERY-LOW LEVELS; HIGH-RISK; CARDIOVASCULAR OUTCOMES; FENOFIBRATE THERAPY; SAFETY; EFFICACY; METAANALYSIS; ASSOCIATION; EVOLOCUMAB;

D O I：

10.1007/s11886-020-01326-w

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Purpose of ReviewThe aim of this report is to review the scientific evidence supporting that lipid lowering therapy (LLT), beyond statins, reduces cardiovascular risk; therefore, treatment strategies based on lipid-lowering drug combination should be implemented.Recent FindingsA strong scientific body of evidence supports the effect of statins on cardiovascular risk reduction. Recent trials using non-statin LLT, ezetimibe, and PCSK9 inhibitors have provide scientific evidence about their impact on cardiovascular prevention. Current clinical guidelines still recommend using high-intensity statin monotherapy before considering combination therapy.SummaryThe causal effect of LDL-C on atherosclerosis is well established. Moreover, new RCT, meta-analysis, and Mendelian randomization data, support that the main determinant of risk reduction is the absolute LDL reduction regardless of LLT. Accordingly, the "high-intensity statin therapy" concept should be substituted by "high-intensity lipid lowering therapy." Combination therapy must become the standard of care of hypercholesterolemia treatment.

引用

页数：10

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