1. Substantial ASCVD risk persists despite low levels of LDL-C and elevated TGs, and their remnants account for a portion of this residual risk.
2. Combination therapy of statins with fibrates or niacin has not shown effectiveness and is generally not recommended to reduce ASCVD event risk.
3. REDUCE-IT was a landmark trial showing that icosapent ethyl 4 g/day in addition to maximally tolerated statin therapy could reduce ASCVD events significantly. However, its impact on TGs appears not to account for all of the substantial benefits of this therapy.
Dr. Nathan Wong is a cardiovascular epidemiologist and Professor and Director, Heart Disease Prevention Program, Division of Cardiology at the University of California, Irvine in California. He holds MPH and PhD degrees in epidemiology from Yale University and is a fellow of the American College of Cardiology, American Heart Association, National Lipid Association, and American Society for Preventive Cardiology He is a past president of the American Society for Preventive Cardiology and Pacific Lipid Association (Chapter of the National Lipid Association), and president-elect of the Interamerican Heart Foundation. Dr. Wong has primary research interests in subclinical atherosclerosis, lipid and diabetes management, and cardiovascular disease epidemiology and prevention and has authored over 300 papers and co-edited six textbooks, including the Braunwald Companion on Preventive Cardiology and the ASPC Manual on Preventive Cardiology.
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