How to assess and manage cardiovascular risk associated with lipid alterations beyond LDL

Maurizio Averna, Miha Cercek, Erik Stroes, Maurizio Averna, Masatsune Ogura, Patrizia Suppressa, Paolo Calabrò, Arman Postadzhiyan, Patrizia Suppressa

Risultato della ricerca: Article

5 Citazioni (Scopus)

Abstract

Background and aims The maintenance of clinically recommended levels of low-density lipoprotein cholesterol (LDL-C) through a statin therapy is a gold standard in the management of patients with dyslipidaemia and cardiovascular disease (CVD). However, even when LDL-C levels are at or below clinically recommended target levels, residual cardiovascular (CV) risk still remains. Therefore, assessing lipoproteins beyond LDL-C in managing CV risk is imperative. Methods A working group of clinical experts have assessed the role of lipoproteins other than LDL-C in identifying the CV risk in patients with dyslipidaemia and CVD and in the management of atherogenic dyslipidaemia associated with a number of other diseases. The recommendations, in line with the European guidelines, are presented. Results A thorough evaluation of clinical data by the expert working group resulted in recommendations to consider non-high-density lipoprotein cholesterol (non-HDL-C), apolipoprotein B (apoB), remnant cholesterol and lipoprotein(a) (Lp[a]) as biomarkers of residual CV risk in patients with CVD. Elevated Lp(a) levels were also suggested to be a causal factor. The experts highlighted the significance of non-HDL-C and triglycerides (TG) in atherogenic dyslipidaemia associated with type 2 diabetes, metabolic syndrome, chronic kidney disease (CKD) and familial combined hyperlipidaemia (FCH). The working group recommended combinatorial therapeutic approaches in high-risk patients, including agents impacting on TG and HDL-C levels. Conclusions Evaluation of a lipoprotein landscape when LDL-C levels remain low strongly supports the role of non-HDL-C, Lp(a) and TGs in identifying patients with increased residual risk of CV and in selecting their treatment strategy.
Lingua originaleEnglish
pagine (da-a)16-24
Numero di pagine9
RivistaAtherosclerosis Supplements
Volume26
Stato di pubblicazionePublished - 2017

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LDL Cholesterol
Dyslipidemias
Lipids
Lipoproteins
Cardiovascular Diseases
Familial Combined Hyperlipidemia
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Lipoprotein(a)
Apolipoproteins B
Proxy
Disease Management
Chronic Renal Insufficiency
Type 2 Diabetes Mellitus
oxidized low density lipoprotein
Triglycerides
Therapeutics
Biomarkers
Cholesterol
Maintenance
Guidelines

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

Cita questo

Averna, M., Cercek, M., Stroes, E., Averna, M., Ogura, M., Suppressa, P., ... Suppressa, P. (2017). How to assess and manage cardiovascular risk associated with lipid alterations beyond LDL. Atherosclerosis Supplements, 26, 16-24.

How to assess and manage cardiovascular risk associated with lipid alterations beyond LDL. / Averna, Maurizio; Cercek, Miha; Stroes, Erik; Averna, Maurizio; Ogura, Masatsune; Suppressa, Patrizia; Calabrò, Paolo; Postadzhiyan, Arman; Suppressa, Patrizia.

In: Atherosclerosis Supplements, Vol. 26, 2017, pag. 16-24.

Risultato della ricerca: Article

Averna, M, Cercek, M, Stroes, E, Averna, M, Ogura, M, Suppressa, P, Calabrò, P, Postadzhiyan, A & Suppressa, P 2017, 'How to assess and manage cardiovascular risk associated with lipid alterations beyond LDL', Atherosclerosis Supplements, vol. 26, pagg. 16-24.
Averna, Maurizio ; Cercek, Miha ; Stroes, Erik ; Averna, Maurizio ; Ogura, Masatsune ; Suppressa, Patrizia ; Calabrò, Paolo ; Postadzhiyan, Arman ; Suppressa, Patrizia. / How to assess and manage cardiovascular risk associated with lipid alterations beyond LDL. In: Atherosclerosis Supplements. 2017 ; Vol. 26. pagg. 16-24.
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abstract = "Background and aims The maintenance of clinically recommended levels of low-density lipoprotein cholesterol (LDL-C) through a statin therapy is a gold standard in the management of patients with dyslipidaemia and cardiovascular disease (CVD). However, even when LDL-C levels are at or below clinically recommended target levels, residual cardiovascular (CV) risk still remains. Therefore, assessing lipoproteins beyond LDL-C in managing CV risk is imperative. Methods A working group of clinical experts have assessed the role of lipoproteins other than LDL-C in identifying the CV risk in patients with dyslipidaemia and CVD and in the management of atherogenic dyslipidaemia associated with a number of other diseases. The recommendations, in line with the European guidelines, are presented. Results A thorough evaluation of clinical data by the expert working group resulted in recommendations to consider non-high-density lipoprotein cholesterol (non-HDL-C), apolipoprotein B (apoB), remnant cholesterol and lipoprotein(a) (Lp[a]) as biomarkers of residual CV risk in patients with CVD. Elevated Lp(a) levels were also suggested to be a causal factor. The experts highlighted the significance of non-HDL-C and triglycerides (TG) in atherogenic dyslipidaemia associated with type 2 diabetes, metabolic syndrome, chronic kidney disease (CKD) and familial combined hyperlipidaemia (FCH). The working group recommended combinatorial therapeutic approaches in high-risk patients, including agents impacting on TG and HDL-C levels. Conclusions Evaluation of a lipoprotein landscape when LDL-C levels remain low strongly supports the role of non-HDL-C, Lp(a) and TGs in identifying patients with increased residual risk of CV and in selecting their treatment strategy.",
keywords = "Apolipoprotein B; Atherogenic dyslipidaemia; Cardiovascular disease; Cardiovascular risk; High-density lipoprotein cholesterol; Lipoprotein(a); Non-high-density lipoprotein cholesterol; Triglycerides; Internal Medicine; Cardiology and Cardiovascular Medicine",
author = "Maurizio Averna and Miha Cercek and Erik Stroes and Maurizio Averna and Masatsune Ogura and Patrizia Suppressa and Paolo Calabr{\`o} and Arman Postadzhiyan and Patrizia Suppressa",
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T1 - How to assess and manage cardiovascular risk associated with lipid alterations beyond LDL

AU - Averna, Maurizio

AU - Cercek, Miha

AU - Stroes, Erik

AU - Averna, Maurizio

AU - Ogura, Masatsune

AU - Suppressa, Patrizia

AU - Calabrò, Paolo

AU - Postadzhiyan, Arman

AU - Suppressa, Patrizia

PY - 2017

Y1 - 2017

N2 - Background and aims The maintenance of clinically recommended levels of low-density lipoprotein cholesterol (LDL-C) through a statin therapy is a gold standard in the management of patients with dyslipidaemia and cardiovascular disease (CVD). However, even when LDL-C levels are at or below clinically recommended target levels, residual cardiovascular (CV) risk still remains. Therefore, assessing lipoproteins beyond LDL-C in managing CV risk is imperative. Methods A working group of clinical experts have assessed the role of lipoproteins other than LDL-C in identifying the CV risk in patients with dyslipidaemia and CVD and in the management of atherogenic dyslipidaemia associated with a number of other diseases. The recommendations, in line with the European guidelines, are presented. Results A thorough evaluation of clinical data by the expert working group resulted in recommendations to consider non-high-density lipoprotein cholesterol (non-HDL-C), apolipoprotein B (apoB), remnant cholesterol and lipoprotein(a) (Lp[a]) as biomarkers of residual CV risk in patients with CVD. Elevated Lp(a) levels were also suggested to be a causal factor. The experts highlighted the significance of non-HDL-C and triglycerides (TG) in atherogenic dyslipidaemia associated with type 2 diabetes, metabolic syndrome, chronic kidney disease (CKD) and familial combined hyperlipidaemia (FCH). The working group recommended combinatorial therapeutic approaches in high-risk patients, including agents impacting on TG and HDL-C levels. Conclusions Evaluation of a lipoprotein landscape when LDL-C levels remain low strongly supports the role of non-HDL-C, Lp(a) and TGs in identifying patients with increased residual risk of CV and in selecting their treatment strategy.

AB - Background and aims The maintenance of clinically recommended levels of low-density lipoprotein cholesterol (LDL-C) through a statin therapy is a gold standard in the management of patients with dyslipidaemia and cardiovascular disease (CVD). However, even when LDL-C levels are at or below clinically recommended target levels, residual cardiovascular (CV) risk still remains. Therefore, assessing lipoproteins beyond LDL-C in managing CV risk is imperative. Methods A working group of clinical experts have assessed the role of lipoproteins other than LDL-C in identifying the CV risk in patients with dyslipidaemia and CVD and in the management of atherogenic dyslipidaemia associated with a number of other diseases. The recommendations, in line with the European guidelines, are presented. Results A thorough evaluation of clinical data by the expert working group resulted in recommendations to consider non-high-density lipoprotein cholesterol (non-HDL-C), apolipoprotein B (apoB), remnant cholesterol and lipoprotein(a) (Lp[a]) as biomarkers of residual CV risk in patients with CVD. Elevated Lp(a) levels were also suggested to be a causal factor. The experts highlighted the significance of non-HDL-C and triglycerides (TG) in atherogenic dyslipidaemia associated with type 2 diabetes, metabolic syndrome, chronic kidney disease (CKD) and familial combined hyperlipidaemia (FCH). The working group recommended combinatorial therapeutic approaches in high-risk patients, including agents impacting on TG and HDL-C levels. Conclusions Evaluation of a lipoprotein landscape when LDL-C levels remain low strongly supports the role of non-HDL-C, Lp(a) and TGs in identifying patients with increased residual risk of CV and in selecting their treatment strategy.

KW - Apolipoprotein B; Atherogenic dyslipidaemia; Cardiovascular disease; Cardiovascular risk; High-density lipoprotein cholesterol; Lipoprotein(a); Non-high-density lipoprotein cholesterol; Triglycerides; Internal Medicine; Cardiology and Cardiovascular Medic

UR - http://hdl.handle.net/10447/232635

UR - http://www.elsevier.com/locate/atherosclerosis

M3 - Article

VL - 26

SP - 16

EP - 24

JO - Atherosclerosis Supplements

JF - Atherosclerosis Supplements

SN - 1567-5688

ER -