Comprehensive Lipid Management in the Coronary Artery Disease Patient

Nivee P. Amin, Michael J. Blaha, Grant V. Chow, Roger S. Blumenthal, Dominique Ashen

Research output: Contribution to journalReview article

Abstract

Low-density lipoprotein cholesterol (LDL-C) is the lipoprotein most implicated in atherosclerosis, and aggressive statin therapy remains the cornerstone of treatment. Adjunct therapies are often required to reach LDL-C goals, and recent studies have only fueled the debate over ezetimibe versus niacin. Alternate dosing regimens of high-potency statins can be used in those who cannot tolerate side effects. Residual risk may remain after LDL-C goals are achieved. Non-high-density lipoprotein cholesterol (non-HDL-C) must be calculated in patients with elevated triglycerides. Omega-3 fatty acids are most effective in lowering non-HDL-C. Low HDL-C levels can be raised with niacin, but clinical events may not be significantly reduced. Newer therapeutic targets, such as cholesteryl ester transfer protein (CETP) inhibitors, raise HDL-C and are being evaluated for safety and efficacy. Several ongoing, randomized controlled trials are investigating the relative efficacy of adjunctive therapies for reducing coronary heart disease events in high-risk patients.

Original languageEnglish (US)
Pages (from-to)399-406
Number of pages8
JournalCurrent Cardiovascular Risk Reports
Volume5
Issue number5
DOIs
StatePublished - Dec 1 2011

Keywords

  • Adjunct therapy
  • Atherosclerosis
  • Cholesteryl ester transfer protein inhibitor
  • Coronary heart disease
  • High density lipoprotein
  • Lipid guidelines
  • Lipid management
  • Low density lipoprotein
  • Niacin
  • Non-high density lipoprotein
  • Omega-3 fatty acid
  • Secondary prevention
  • Statin
  • Triglycerides

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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