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Lipid-Lowering Therapy after Acute Coronary Syndrome.
Pogran, Edita; Burger, Achim Leo; Zweiker, David; Kaufmann, Christoph Clemens; Muthspiel, Marie; Rega-Kaun, Gersina; Wenkstetten-Holub, Alfa; Wojta, Johann; Drexel, Heinz; Huber, Kurt.
Afiliación
  • Pogran E; 3rd Medical Department for Cardiology and Intensive Care Medicine, Klinik Ottakring, 1160 Vienna, Austria.
  • Burger AL; Medical Faculty, Sigmund Freud University, 1020 Vienna, Austria.
  • Zweiker D; 3rd Medical Department for Cardiology and Intensive Care Medicine, Klinik Ottakring, 1160 Vienna, Austria.
  • Kaufmann CC; Medical Faculty, Sigmund Freud University, 1020 Vienna, Austria.
  • Muthspiel M; 3rd Medical Department for Cardiology and Intensive Care Medicine, Klinik Ottakring, 1160 Vienna, Austria.
  • Rega-Kaun G; 3rd Medical Department for Cardiology and Intensive Care Medicine, Klinik Ottakring, 1160 Vienna, Austria.
  • Wenkstetten-Holub A; Medical Faculty, Sigmund Freud University, 1020 Vienna, Austria.
  • Wojta J; 3rd Medical Department for Cardiology and Intensive Care Medicine, Klinik Ottakring, 1160 Vienna, Austria.
  • Drexel H; Medical Faculty, Sigmund Freud University, 1020 Vienna, Austria.
  • Huber K; 5th Medical Department with Endocrinology, Rheumatology and Acute Geriatrics, Klinik Ottakring, 1160 Vienna, Austria.
J Clin Med ; 13(7)2024 Apr 01.
Article en En | MEDLINE | ID: mdl-38610808
ABSTRACT
Achieving guideline-recommended low-density lipoprotein cholesterol (LDL-C) targets remains a significant challenge in clinical practice. This review assesses the barriers to reaching LDL-C goals and explores the potential solutions to these issues. When aiming for the recommended LDL-C goal, strategies like "lower is better" and "strike early and strong" should be used. The evidence supports the safety and efficacy of intensive lipid-lowering therapy post-acute coronary syndrome (ACS), leading to improved long-term cardiovascular health and atherosclerotic plaque stabilization. Despite the availability of effective lipid-lowering therapies, such as high-intensity statins, ezetimibe, the combination of both, bempedoic acid, and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, a substantial proportion of patients do not meet their LDL-C targets. Contributing factors include systemic healthcare barriers, healthcare provider inertia, patient non-adherence, and statin intolerance. Statin intolerance, often rather statin reluctance, is a notable obstacle due to perceived or expected side effects, which can lead to discontinuation of therapy. In conclusion, while there are obstacles to achieving optimal LDL-C levels post-ACS, these can be overcome with a combination of patient-centric approaches, clinical vigilance, and the judicious use of available therapies. The safety and necessity of reaching lower LDL-C goals to improve outcomes in patients post-ACS are well-supported by current evidence.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Med Año: 2024 Tipo del documento: Article País de afiliación: Austria Pais de publicación: Suiza

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Med Año: 2024 Tipo del documento: Article País de afiliación: Austria Pais de publicación: Suiza