Maerz, Winfried, Scharnagl, Hubert, Gouni-Berthold, Ioanna, Silbernagel, Guenther, Dressel, Alexander, Grammer, Tanja B., Landmesser, Ulf, Dieplinger, Hans, Windler, Eberhard and Laufs, Ulrich (2016). LDL-Cholesterol: Standards of Treatment 2016: A German Perspective. Am. J. Cardiovasc. Drugs, 16 (5). S. 323 - 337. NORTHCOTE: ADIS INT LTD. ISSN 1179-187X

Full text not available from this repository.

Abstract

Decreasing low-density lipoprotein cholesterol (LDL-C) is one of the few established and proven principles for the prevention and treatment of atherosclerosis. The higher the individual cardiovascular risk, the higher the benefit of lipid-lowering pharmacotherapy. Therefore, treatment options are chosen based on a patient's total cardiovascular risk. The latter depends not only on the levels of LDL-C but also on the presence of cardiovascular disease (CVD) and on the number and severity of other risk factors. Current guidelines recommend the lowering of LDL-C to 115 mg/dl (3 mmol/l) in patients with low and moderate risk. The LDL-C treatment target is < 100 mg/dl (2.6 mmol/l) for patients at high risk and < 70 mg/dl (1.8 mmol/l) for patients at very high risk. Although lifestyle measures remain a fundamental part of treatment, many patients require drug therapy to achieve their LDL-C targets. Statins are the drugs of choice, with other options including ezetimibe and the newly available monoclonal antibodies against PCSK9 (proprotein convertase subtilisin/kexin type 9). In some cases, bile acid-binding sequestrants and fibrates can also be considered. Nicotinic acid is no longer available in Germany. PCSK9 antibodies decrease LDL-C about 50-60 % and are well tolerated. Their effects on clinical endpoints are being investigated in large randomized trials. The aim of the present review is to summarize the current guidelines and treatment options for hypercholesterolemia. Moreover, we provide an appraisal of PCSK9 antibodies and propose their use in selected patient populations, particularly in those at very high cardiovascular risk whose LDL-C levels under maximally tolerated lipid-lowering therapy are significantly over their treatment target.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Maerz, WinfriedUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Scharnagl, HubertUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gouni-Berthold, IoannaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Silbernagel, GuentherUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dressel, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Grammer, Tanja B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Landmesser, UlfUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dieplinger, HansUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Windler, EberhardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Laufs, UlrichUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-261920
DOI: 10.1007/s40256-016-0179-y
Journal or Publication Title: Am. J. Cardiovasc. Drugs
Volume: 16
Number: 5
Page Range: S. 323 - 337
Date: 2016
Publisher: ADIS INT LTD
Place of Publication: NORTHCOTE
ISSN: 1179-187X
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
HOMOZYGOUS FAMILIAL HYPERCHOLESTEROLEMIA; SUBTILISIN/KEXIN TYPE 9; DENSITY-LIPOPROTEIN CHOLESTEROL; CORONARY-HEART-DISEASE; CARDIOVASCULAR-RISK PATIENTS; STATIN-INTOLERANT PATIENTS; EVOLOCUMAB AMG 145; DOUBLE-BLIND; INDIVIDUAL DATA; MONOCLONAL-ANTIBODYMultiple languages
Cardiac & Cardiovascular Systems; Pharmacology & PharmacyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/26192

Downloads

Downloads per month over past year

Altmetric

Export

Actions (login required)

View Item View Item