Journal Article

Treating lipids in cardiovascular disease: new directions

O. Wiklund

in European Heart Journal Supplements

Published on behalf of European Society of Cardiology

Volume 3, issue suppl_B, pages B27-B31
Published in print May 2001 | ISSN: 1520-765X
Published online May 2001 | e-ISSN: 1554-2815 | DOI: http://dx.doi.org/10.1016/S1520-765X(01)90054-9
Treating lipids in cardiovascular disease: new directions

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Aims To review the importance of lipid parameters beside low-density lipoprotein (LDL) levels as risk factors for cardiovascular disease, and their potential as therapeutic targets for lipid-lowering agents.

Methods and Results Large numbers of studies have shown that, as well as high low-density lipoprotein (LDL) levels, low high-density lipoprotein (HDL) levels and a high LDL/HDL ratio are important cardiovascular disease risk factors. The new generation of statins, such as cerivastatin, demonstrates greater potency in getting more patients to their LDL-C targets, as recommended by the U.S. NCEP guidelines. Statins and also fibrates can increase HDL levels. In the VA-HIT study, for example, a 6% increase in HDL level using gemfibrozil was associated with a 22% reduction in the relative risk of coronary events compared with placebo. Statin treatment, by decreasing LDL and increasing HDL levels, produces strong reductions in the LDL/HDL ratio. In a cerivastatin study, the percentage of patients with LDL/HDL ratio <3 (low risk of coronary heart disease) increased from 32% (baseline) to 90% after 8 weeks of therapy. The density of LDL particles also affects cardiovascular disease risk. Studies have shown that small dense LDL particles have atherogenic properties, and that lipid-lowering therapy can alter the LDL density profile. The TRIGMA trial is investigating the effect of cerivastatin on LDL particle size and triglyceride levels in patients with type 2 diabetes.

Conclusions Other lipid parameters, besides LDL levels, can provide new targets for lipid intervention therapy.

Keywords: Cardiovascular disease; low-density lipoprotein; high-density lipoprotein; statins; cerivastatin

Journal Article.  0 words. 

Subjects: Cardiovascular Medicine

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