YEAR IN REVIEW DYSLIPIDAEMIA IN 2013
New statin guidelines and promising novel therapeutics Dimitri P. Mikhailidis and Vasilios G. Athyros
The new ACC/AHA guidelines on treatment of blood cholesterol focus on intensity of statin therapy rather than target levels of lipids. Early studies show substantial reductions in LDL-cholesterol level with antibodies against PCSK9. MicroRNA silencing and gene-repair techniques to treat dyslipidaemia are promising strategies under development. Mikhailidis, D. P. & Athyros, V. G. Nat. Rev. Cardiol. advance online publication 24 December 2013; doi:10.1038/nrcardio.2013.209
In this Year in Review article, we discuss the main advances in the prevention and treatment of dyslipidaemia during 2013. The new ACC/AHA practice guidelines for the treatment of blood cholesterol, the aim of which is to reduce the risk of atherosclerotic cardiovascular disease (ASCVD), include new equations to estimate this risk.1 These equations are based on the pooled results of five large cohort studies and consider age, sex, ethnicity, total-cholesterol and HDL-cholesterol (HDL‑C) levels, systolic blood pressure, presence of diabetes mellitus, smoking status, and treatment for hypertension.1 As in the Framingham equation, a family history of premature ASCVD is missing, but the risk of stroke is included, which is useful. These guidelines do not set treatment targets for LDL cholesterol (LDL‑C) or non-HDL‑C.1 Instead, they focus on the intensity of statin therapy to reduce ASCVD risk in combination with a healthy lifestyle.1 High-intensity statin therapy, which lowers the LDL‑C level by ≥50%, is recommended mainly for the secondary prevention of ASCVD. Moderate-to-high intensity statin therapy, which lowers the LDL‑C level by 30–50%, is recommended for primary prevention in patients at high risk of ASCVD. Low-intensity statin therapy, which lowers the LDL‑C level by 85 mg/dl; 45% at high risk of ASCVD). Participants also received a stable dose of a statin, with or without ezetimibe. Up to 90% and 97% of individuals receiving AMG 145 every 2 weeks or 4 weeks, respectively, attained the LDL‑C target level of
New statin guidelines and promising novel therapeutics Dimitri P. Mikhailidis and Vasilios G. Athyros
The new ACC/AHA guidelines on treatment of blood cholesterol focus on intensity of statin therapy rather than target levels of lipids. Early studies show substantial reductions in LDL-cholesterol level with antibodies against PCSK9. MicroRNA silencing and gene-repair techniques to treat dyslipidaemia are promising strategies under development. Mikhailidis, D. P. & Athyros, V. G. Nat. Rev. Cardiol. advance online publication 24 December 2013; doi:10.1038/nrcardio.2013.209
In this Year in Review article, we discuss the main advances in the prevention and treatment of dyslipidaemia during 2013. The new ACC/AHA practice guidelines for the treatment of blood cholesterol, the aim of which is to reduce the risk of atherosclerotic cardiovascular disease (ASCVD), include new equations to estimate this risk.1 These equations are based on the pooled results of five large cohort studies and consider age, sex, ethnicity, total-cholesterol and HDL-cholesterol (HDL‑C) levels, systolic blood pressure, presence of diabetes mellitus, smoking status, and treatment for hypertension.1 As in the Framingham equation, a family history of premature ASCVD is missing, but the risk of stroke is included, which is useful. These guidelines do not set treatment targets for LDL cholesterol (LDL‑C) or non-HDL‑C.1 Instead, they focus on the intensity of statin therapy to reduce ASCVD risk in combination with a healthy lifestyle.1 High-intensity statin therapy, which lowers the LDL‑C level by ≥50%, is recommended mainly for the secondary prevention of ASCVD. Moderate-to-high intensity statin therapy, which lowers the LDL‑C level by 30–50%, is recommended for primary prevention in patients at high risk of ASCVD. Low-intensity statin therapy, which lowers the LDL‑C level by 85 mg/dl; 45% at high risk of ASCVD). Participants also received a stable dose of a statin, with or without ezetimibe. Up to 90% and 97% of individuals receiving AMG 145 every 2 weeks or 4 weeks, respectively, attained the LDL‑C target level of
