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Lipid-lowering therapy: Guidelines to precision medicine

期刊

CLINICA CHIMICA ACTA
卷 514, 期 -, 页码 66-73

出版社

ELSEVIER
DOI: 10.1016/j.cca.2020.12.019

关键词

Dyslipidemia; Low-density lipoprotein cholesterol; Cardiovascular diseases; Statins; PCSK9 inhibitors; Clinical precision medicine

资金

  1. National Key Research and Development Program of China [2016YFC1301202]

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Dyslipidemia is associated with various health issues, and statins are highlighted as the cornerstone for lowering LDL-C. Other medications, like PCSK9 inhibitors, are being researched for their effectiveness in reducing circulating LDL-C. Guidelines emphasize individualized clinical precision medicine for dyslipidemia management, focusing on the importance of LDL-C reduction in preventing cardiovascular disease.
Dyslipidemia is correlated with a series of health problems, such as obesity, insulin resistance, and the development of cardiovascular disease (CVD). Currently, accumulating evidence sheds light on the fact that beta-hydroxy p-methylglutaryl-CoA reductase inhibitors, named statins, could lower circulating lipid-density lipoprotein cholesterol (LDL-C) and represent a revolution for the prevention of metabolic disorder diseases. In addition, statins remain the cornerstone of LDL-C-lowering treatments, together with ezetimibe and bile acid sequestrants, which are used either in combination with statins or as monotherapies in the case of statin intolerance or side effects. On the other hand, other medicines that reduce circulating LDL-C have also been researched, including inhibitors of protein convertase subtilisin/kexin type 9 (PCSK9). More recently, PCSK9 inhibitors have been approved for the secondary prevention of CVD and for the atherogenic dyslipidemia therapy. Here, we summarize the latest guidelines for the management of dyslipidemia and its relation to CVD, focusing on LDL-C-lowering medicines that are either available in daily clinical practice or under investigation. In addition, we also discuss the who, when, and how with respect to treating patients with dyslipidemia according to LDL-C reduction as an individualized clinical precision medicine.

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