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Is there a role for non-statin based treatments in dyslipidaemia?

Diabetes and the Heart

Is There a Role for Non-Statin Based Treatments in Dyslipidaemia?
The answer was yes. During the joint Symposium organized by the ESC and the International Society of Cardiovascular Pharmacotherapy, chaired by Drs I.M. Graham (Dublin, Ireland) and A.J. Lorenzatti (Cordoba, Argentina) the implications of non-statin intervention in daily clinical practice were analyzed.

In first position, the role of fibrates was presented by Dr L. Tokgozoglu (Ankara, TR) who remarked that LDL lowering with statins-based therapies is the standard of care for dyslipidaemic patients, but events are still high and additional interventions are needed. Regarding fibrates, there is no conclusive evidence about their use for cardiovascular protection to decrease remaining risk, but adding fibrates to a statin is considered relatively safe and may be considered in high risk type 2 diabetes mellitus high-risk subgroups with elevated triglycerides and low HDL-cholesterol.

Prof. Barter (Sydney, Australia), also analyzed the latest two negative trials using niacin (AIM-HIGH and HPS2) and stated that the future utilization of this drug is uncertain.

Prof. Santos (Sao Paulo, Brazil) reviewed the mechanisms of action and clinical value of ezetimibe, and concluded that this drug reduces pro-atherogenic plasma lipoproteins and atherosclerosis in experimental models and remarked on its clinical use in severe hypercholesterolemias as an adjunct to high dose statins. Also, he commented on the good results of the statin/ezetimibe combination in terms of cardiovascular disease reduction in chronic kidney disease patients, but the final verdict is still awaited when the IMPROVE-IT study is completed.

Finally, Dr Kromhout (Wageningen, Netherlands) stated that the combination of statins and omega-3 fatty acids is optimal for lowering the risk of major cardiovascular events in post-MI patients, remarking that for the subset of post-MI patients who do not tolerate statins, omega-3 fatty acids could be one of the alternatives to reduce major cardiovascular events.




Is there a role for non-statin based treatments in dyslipidaemia?

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.