Trials in “True” Dyslipidemic Patients Are Urged to Reconsider Comprehensive Lipid Management as a Means to Reduce Residual Cardiovascular Risk

Research output: Contribution to journalReview article

Abstract

Randomized cardiovascular trials aimed to reduce the excessive residual risk in high-risk patients through a more aggressive low-density lipoprotein-cholesterol control or targeting triglycerides or high-density lipoprotein-cholesterol levels have shown a null or, at best, limited incremental benefit. In some cases, the treatment produced meaningful effects only in study subgroups. As a consequence, some compounds were withdrawn (e.g., nicotinic acid derivatives and cholesteryl ester transfer protein inhibitors), whereas others (fibrates) are utilized with reluctance due to the low level of evidence-based data. By reviewing these trials analytically, we identified a common feature that might explain their meager results: most of them involved patients generically at high cardiovascular risk with normal or near normal lipid levels and not patients with “true” dyslipidemia, who would receive the treatment if it were part of usual care. These observations may warrant re-examining a central criterion of pragmatism, eligibility, in the outline of forthcoming cardiovascular trials with novel lipid-modifying drugs.

Original languageEnglish
Pages (from-to)960-967
Number of pages8
JournalClinical Pharmacology and Therapeutics
Volume106
Issue number5
DOIs
Publication statusPublished - Nov 1 2019

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

Fingerprint Dive into the research topics of 'Trials in “True” Dyslipidemic Patients Are Urged to Reconsider Comprehensive Lipid Management as a Means to Reduce Residual Cardiovascular Risk'. Together they form a unique fingerprint.

  • Cite this