PCSK9 inhibitors: Ratification of the role of LDL cholesterol in cardiovascular prevention. Towards a convergence of European and North American prevention guidelines?

Publication date: Available online 1 August 2019Source: Revista Clínica Española (English Edition)Author(s): C. Guijarro, M. CamafortAbstractThe epidemiological association of cholesterol associated with low density lipoproteins (LDL-c) levels and the development of atherosclerotic vascular disease has been ratified by mendelian randomization studies. Paradoxically, the success of statins led to the underestimation of other lipid-lowering therapies and even the measurement of LDL-c. Recent studies show that the reduction of LDL-c to extraordinarily low levels through absorption inhibition, and, in a particularly intensive manner, with monoclonal antibodies against pro-protein convertase subtilisine kexine 9 (PCSK9) continues to offer cardiovascular protection. However, the high cost and limited experience with PCSK-9 inhibitors advised a prudent use of them. An appropriate selection of patients most likely to benefit from treatment with PCSK9 inhibitors emerges as the basis for a consensus of international guidelines: the combination of a high absolute vascular risk and a greater expected benefit by the starting LDL-c levels.ResumenLa asociación epidemiológica entre los niveles de colesterol asociado a lipoproteínas de baja densidad (c-LDL) y el desarrollo de enfermedad vascular aterosclerosa ha sido ratificada mediante estudios de aleatorización mendeliana. Paradójicamente, el éxito de las estatinas condujo a minusvalorar otros tratamientos hipolipidemiantes e inclus...
Source: Revista Clinica Espanola - Category: Internal Medicine Source Type: research