Lipid-lowering therapies in patients undergoing percutaneous coronary intervention

Chan Joon Kim, Katherine Godfrey, Swagata Patnaik, Roxana Mehran

Research output: Contribution to journalReview articlepeer-review

Abstract

Cardiovascular disease is the leading cause of death worldwide. Over past decades, multiple clinical trials have provided substantial evidence supporting the advantages of managing plasma lipids in individuals with coronary artery disease (CAD). A primary focus in reducing clinical atherosclerotic cardiovascular disease (ASCVD) in patients who have undergone percutaneous coronary intervention (PCI) is the regulation of blood lipids, with an emphasis on low-density lipoprotein (LDL) cholesterol. Statins represent the cornerstone of lipid-lowering therapy (LLT), with high-intensity statins consistently associated with beneficial outcomes in patients at high risk of ASCVD. Nevertheless, a notable portion of patients do not achieve their target cholesterol levels through statin monotherapy, necessitating the inclusion of complementary LLT strategies. Among these therapies are ezetimibe and proprotein convertase subtilisin/kexin type 9 inhibitors, which have also demonstrated clinical advantages by further reducing cholesterol levels. Existing guidelines recommend using these agents when maximally tolerated statin doses fall short of achieving target LDL levels. Additionally, recently introduced ATP-citrate lyase inhibitors, such as bempedoic acid, have gained approval as adjunctive treatments. Furthermore, icosapent ethyl, a purified derivative of eicosapentaenoic acid, targets hypertriglyceridemia and has shown cardiovascular benefits compared to placebo. In this article, we delve into the mechanisms of blood lipids and molecular targets in connection with CAD undergoing PCI. We also explore the current landscape of available LLT options, guidelines in practice, and the subtleties of therapy.

Original languageEnglish
Article number18
JournalVessel Plus
Volume8
DOIs
StatePublished - 2024

Keywords

  • 3-hydroxy-methylglutaryl coenzyme A inhibitors
  • cardiovascular disease
  • ezetimibe
  • familial hypercholesterolemia
  • hypertriglyceridemia
  • icosapent ethyl
  • low-density lipoprotein
  • non-statin lipid-lowering therapies
  • PCSK9 inhibitors

Fingerprint

Dive into the research topics of 'Lipid-lowering therapies in patients undergoing percutaneous coronary intervention'. Together they form a unique fingerprint.

Cite this