Lipid-modifying agents, from statins to PCSK9 inhibitors
| Autor: | Christina Reith, David Preiss, Jonathan A. Tobert, G. Kees Hovingh |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Statin
medicine.drug_class Cholesterol business.industry LIPID MODIFYING AGENTS 030204 cardiovascular system & hematology Bioinformatics law.invention 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Ezetimibe Randomized controlled trial chemistry law Mendelian randomization medicine lipids (amino acids peptides and proteins) 030212 general & internal medicine Cardiology and Cardiovascular Medicine business PCSK9 Inhibitors medicine.drug Lipoprotein |
| Popis: | Mendelian randomization studies and randomized trials have conclusively demonstrated that lower LDL-cholesterol results in fewer cardiovascular events. This review describes key stages in the evolution of LDL-cholesterol lowering treatment. Data from over 25 cardiovascular outcome trials confirm that, within a few years, statins lower the relative risk of major atherosclerotic events by about 22% per 38.7 mg/dL (1 mmol/L) reduction in LDL-cholesterol, with similar benefit across patient subgroups. Meta-analyses of these trials have established the safety of statins with regard to non-vascular mortality and cancer. Other agents available for prescription include ezetimibe and PCSK9 inhibitors, which both reduce major atherosclerotic events in proportion to their effects on LDL-cholesterol and have good safety profiles, though PCSK9 inhibitors remain costly. Investigational LDL-cholesterol-lowering agents currently being tested in cardiovascular outcome studies are bempedoic acid, an ATP-citrate lyase inhibitor that reduces cholesterol synthesis, and inclisiran, a double-stranded small interfering RNA, that inhibits PCSK9 synthesis |
| Databáze: | OpenAIRE |
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