Aggressive LDL-C reduction using statin and non-statin therapies is increasingly recommended in clinical guidelines to address residual atherosclerotic cardiovascular disease risk.
This review highlights the historical evolution and current evidence supporting more aggressive LDL-C lowering targets and the use of non-statin therapies to address residual ASCVD risk.
Over the last half-century, discussions on the exact targets for low-density lipoprotein cholesterol (LDL-C) reduction have evolved towards a more aggressive approach with lower LDL-C targets, particularly for high-risk patients with pre-existing atherosclerotic cardiovascular disease (ASCVD). A wealth of cardiovascular outcome trials have shown the efficacy of statin therapy in general, as well as the incremental impact of high-intensity statin therapy in particular. More recent trials have further demonstrated the impact of non-statin therapies, including ezetimibe, proprotein convertase subtilisin/kexin type 9 inhibitors, and, most recently, bempedoic acid, on reducing ASCVD outcomes. The availability of these and other newer therapies has prompted clinicians to strive for lower LDL-C targets to address residual ASCVD risk after statin therapy. This paper will provide an overview of the historical trends in lipid management and therapeutics and review the current state of evidence for lower LDL-C targets in clinical guidelines and recommendations.
Jones et al. (Thu,) conducted a review in Atherosclerotic cardiovascular disease (ASCVD). LDL-C lowering therapies was evaluated. Aggressive LDL-C reduction using statin and non-statin therapies is increasingly recommended in clinical guidelines to address residual atherosclerotic cardiovascular disease risk.
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