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Determinants of Achieved LDL Cholesterol and “Non-HDL” Cholesterol in the Management of Dyslipidemias

  • Lipid Abnormalities and Cardiovascular Prevention (G De Backer, Section Editor)
  • Published:
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Abstract

Purpose of Review

The advent of combination therapy to provide LDL lowering beyond that achieved with statins necessitates the development of greater understanding of how drugs work together, what changes occur in key lipoprotein fractions, and what residual risk remains.

Recent Findings

Clinical trials of agents that, when added to statins, generate profound LDL lowering have been successful in reducing further the risk of cardiovascular disease. LDL cholesterol can be now decreased to unprecedented levels, so the focus of attention then shifts to other apolipoprotein B-containing, atherogenic lipoprotein classes such as lipoprotein(a) and remnants of the metabolism of triglyceride-rich particles. “Non-HDL cholesterol” is used increasingly (especially if measured in the non-fasting state) as a more comprehensive index of risk.

Summary

Metabolic studies reveal how current drugs act in combination to achieve profound lipid lowering. However, care is needed in interpreting achieved LDLc and non-HDLc levels in the emerging treatment paradigm.

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  1. Institute of Cardiovascular and Medical Sciences, University of Glasgow, Ground Floor, Room G31, McGregor Building, University Avenue, Glasgow, G12 8QQ, UK

    Chris J. Packard

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Chris J. Packard reports grants/honoraria from the following pharmaceutical companies: Merck, Sharp & Dohme, Pfizer, Amgen, Sanofi, Regeneron, and Daiichi-Sankyo.

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This article is part of the Topical Collection on Lipid Abnormalities and Cardiovascular Prevention

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Packard, C.J. Determinants of Achieved LDL Cholesterol and “Non-HDL” Cholesterol in the Management of Dyslipidemias. Curr Cardiol Rep 20, 60 (2018). https://doi.org/10.1007/s11886-018-1003-x

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