ChallengesInadequate response in those at high-risk or those with very high low-density lipoprotein cholesterol (LDL-C) levels. Intolerance to available therapy or at higher doses.Short- and long-term side effects of therapy with the current lip..Read More

ODYSSEY OUTCOMES trialCompared with placebo in patients with recent acute coronary syndrome (ACS), alirocumab 75 or 150 mg subcutaneous Q2W targeting LDL-C levels 25-50 mg/dL and allowing levels as low as 15 mg/dL:Reduced major adverse cardiovas..Read More

Risk assessmentHigh-risk group: Atherogenic dyslipidemia, MetS, diabetes, genetics, Lp(a), diet, visceral adiposity and environment.TestingQRISK3, lipids including Lp(a), consider coronary artery calcium score (CACS).Lifestyle adviceCulturally a..Read More

During the first-month post-ACS, the risk of cardiovascular (CV) events is the highest.Trials of high-intensity statins have shown a reduction in MACE in the acute, early and late phases of ACS.The level of LDL-C is directly linked to the amount..Read More

Uniformity in the use of dyslipidemia guidelines to be emphasized as patients in India often consult many physicians over time: to avoid contradictory advice that negatively impacts adherence.There is a need to educate physicians regarding famil..Read More

Statins are the most common, widely prescribed first choice medication for lipid-lowering.Inability to take statins to achieve the target LDL-C for the individual.Inability is due to adverse effects or due to unacceptable elevation of liver enzy..Read More

The CV event rates in elderly subjects are proportionately higher than for younger subjects in primary and secondary prevention studies emphasizing increased absolute risk.Multimorbidity, frailty, dementia and polypharmacy can affect the efficac..Read More

Nonalcoholic fatty liver disease (NAFLD) is associated with metabolic factors, and insulin resistance, type 2 diabetes and CVD are the most common cause of death.NAFLD-important health issue in India.Statins are used to treat atherogenic dyslipi..Read More

Diabetic dyslipidemia is characterized by hypertriglyceridemia, high levels of apoB, non-HDL-C and small-dense LDL particles.Moderate- to high-intensity statins remain the cornerstone for treatment of diabetic dyslipidemia based on ASCVD risk an..Read More

What to measure?Lab results: TGs, remnant cholesterol, non-HDL-C.What you estimate?TGs in remnants + LDL + HDL; remnant cholesterol, cholesterol in remnants + LDL + Lp(a).Remnant (VLDL) cholesterol explains residual ASCVD risk.Treatment increasi..Read More

Both are worthy and detailed but may be far too complex for general use.Why were the simple communication tools for young people of relative risk and risk age dropped from the prevention guidelines?SCORE2 and SCORE2-OP are to be applauded but ar..Read More

Stroke is a leading cause of morbidity and mortality.Relationship between stroke, lipids and statins is complex. The benefits of statins in primary and secondary prevention of stroke are backed by extensive evidence.Theoretical risk of intracere..Read More

Although a number of questions remain unanswered, the available evidence supports that statins do increase the chances of type 2 diabetes mellitus (T2DM) with some statins being more strongly related (e.g., simvastatin, rosuvastatin and atorvast..Read More

There are currently no sex-specific guidelines for the evaluation and management of lipids.Lipids are impacted by normal hormonal changes in women throughout their life cycle.Management of lipids should incorporate sex-specific CV risk-factors.F..Read More

Unanswered questionsIf statins are beneficial, is it due to lipid-lowering or “pleiotropic” effects?Is the benefit similar in ischemic vs. nonischemic heart failure?Is low cholesterol associated with poor outcomes in heart failure?Could stat..Read More