Cited by 439Lipoproteins and Cardiovascular HealthDiabetes, Cardiovascular Risks, and LipoproteinsLipid metabolism and disorders

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Residual Cardiovascular Risk Despite Optimal LDL Cholesterol Reduction with Statins: The Evidence, Etiology, and Therapeutic Challenges

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Sampson, Uchechukwu K., Fazio, Sergio, Linton, MacRae F.·2012·Current Atherosclerosis Reports

DOI 10.1007/s11883-011-0219-7PMC PMC3697085

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Abstract

This review captures the existence, cause, and treatment challenges of residual cardiovascular risk (CVR) after aggressive low-density lipoprotein cholesterol (LDL-C) reduction. Scientific evidence implicates low high-density lipoprotein cholesterol (HDL-C) and high triglycerides (TG) in the CVR observed after LDL-C lowering. However, the Action to Control Cardiovascular Risk in Diabetes (ACCORD) lipid trial with fenofibrate, the Investigation of Lipid Level Management to Understand its Impact in Atherosclerotic Events (ILLUMINATE) study with torcetrapib, and the recently terminated Atherothrombosis Intervention in Metabolic Syndrome with Low HDL Cholesterol/High Triglyceride and Impact on Global Health Outcomes (AIM-HIGH) study with niacin, do not clearly attribute risk reduction value to HDL-C/TG modulation. The optimum approach to long-term lipid-modifying therapies for CVR reduction remains uncertain. Consequently, absolute risk modulation via lifestyle changes remains the centerpiece of a strategy addressing the physiologic drivers of CVR associated with HDL-C/TG, especially in the context of diabetes/metabolic syndrome.

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1 retracted

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“However, it has been acknowledged that a high residual CVD risk still exists, with a considerable proportion of potential CVD “candidates” being underestimated, and therefore, the need for the identification of novel biomarkers, especially of lipid/lipoprotein metabolism, is emerged [10].”
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Novel drug discovery strategies for atherosclerosis that target necrosis and necroptosis
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Stachteas, P., Karakasis, P., Patoulias, D., Clemenza, F., Fragakis, N., & Rizzo, M. (2023) · Annals of Medicine · doi:10.1080/07853890.2024.2304667 · Cited by 35
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Coenzyme Q10 as Treatment for Statin-Associated Muscle Symptoms—A Good Idea, but…
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“Despite use of cholesterol-4 lowering statins, quite often a residual vascular risk remains [Sampson et al, 2012].”
Background
HDL quality and functionality: what can proteins and genes predict?
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Background
HDL particle functionality as a primary pharmacological target for HDL-based therapies
Kypreos, K. E., Gkizas, S., Rallidis, L. S., & Karagiannides, I. (2013) · Biochemical Pharmacology · doi:10.1016/j.bcp.2013.03.004 · Cited by 30
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“and (4) specific fragment ions (m/z: 227.”
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RP1-13D10.2 Is a Novel Modulator of Statin-Induced Changes in Cholesterol
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“Although statin efficacy for reducing cardiovascular disease mortality has been well established, there is still substantial residual risk on treatment, and interindividual response with regard to statin effects on cholesterol lowering remains a concern.(2)”
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“cular risk is not eliminated by statin therapy, even in patients who achieve their LDL-C target [7].”
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Roy, P., Ali, A. J., Kobiyama, K., Ghosheh, Y., & Ley, K. F. (2020) · Vaccine · doi:10.1016/j.vaccine.2019.12.039 · Cited by 29
“Although these interventions are among the most successful prevention strategies known in medicine, significant residual risk persists due to ongoing inflammation [3].”
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Krüppel-like factor 14 deletion in myeloid cells accelerates atherosclerotic lesion development
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“However, despite advances in therapeutics aimed at lowering LDL-C level, residual cardiovascular risks remain in coronary heart disease patients.(3)”
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Yu, X., He, L.-H., Gao, J., Zhang, D., Zheng, X., & Tang, C. (2018) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2018.10.004 · Cited by 28
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“Reports suggest that improvement in lipid profile and blood glucose and anthropometric parameters is associated with reduced risk of coronary and vascular events.(35,36) Triphala has been reported to lower lipid and anthropometric parameters, which could reduce cardiometabolic risk.”
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Kosugi, T., Eriguchi, M., Yoshida, H., Tasaki, H., Fukata, F., Nishimoto, M., Matsui, M., Samejima, K., Iseki, K., Fujimoto, S., et al. (2021) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2021.08.004 · Cited by 28
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Noh, Y., Park, J. Y., Choi, B. G., Kim, K.-E., & Rha, S. (2019) · Journal of Medical Systems · doi:10.1007/s10916-019-1359-5 · Cited by 25
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Background
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Background
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Neglia, D., Caselli, C., Maffei, E., Cademartiri, F., Meloni, A., Bossone, E., Saba, L., Lee, S., Sung, J. M., Andreini, D., et al. (2024) · Circulation Cardiovascular Imaging · doi:10.1161/circimaging.123.016481 · Cited by 25
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Background
Angiopoietin-Like 3 Antibody Therapy in Patients With Suboptimally Controlled Hyperlipidemia
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Self-citation
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“[1–3] Patients still suffer substantial residual cardiovascular risk even if the CVD risk was significantly reduced in patients using appropriate treatment with statins.[4] An elevated triglyceride level was considered as an independent factor for the high residual risk on subsequent CVD.”
Background
Residual cardiovascular risk in patients who received lipid-lowering treatment in a real-life setting: retrospective study
Perrone, V., Sangiorgi, D., Buda, S., & Esposti, L. D. (2016) · ClinicoEconomics and Outcomes Research · doi:10.2147/ceor.s107992 · Cited by 23
“efficacy of the current statin-based therapies, several studies have observed that many patients treated with statins do not reach the therapeutic goal while remaining at risk of future CV events.(17) Our results are in agreement with these previous analyses, as they show that the incremental risk of CV events increas…”
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“However, the risk of ASCVD remains even after lowering LDL cholesterol (LDL-C) to a normal concentration [1-3].”
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Background
Eligibility, Clinical Outcomes, and Budget Impact of PCSK9 Inhibitor Adoption: The CANHEART PCSK9 Study
Ko, D. T., Khan, A. M., Kotrri, G., Austin, P. C., Wijeysundera, H. C., Koh, M., Chu, A., Jackevicius, C. A., Lawler, P. R., & Tu, J. V. (2018) · Journal of the American Heart Association · doi:10.1161/jaha.118.010007 · Cited by 22
“Despite treatment, patients continue to be at significantly increased risk for adverse cardiac events in the long term.(2) The ability of PCSK9i (proprotein convertase subtilisin-kexin type 9 inhibitors) to substantially reduce LDL cholesterol has ushered in a new era of managing patients with ASCVD.”
Background
Relation of Cardiovascular Events and Deaths to Low-Density Lipoprotein Cholesterol Level Among Statin-Treated Patients With Atherosclerotic Cardiovascular Disease
Chamberlain, A. M., Cohen, S. S., Weston, S. A., Fox, K. M., Xiang, P., Killian, J. M., & Qian, Y. (2019) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2019.02.043 · Cited by 22
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“In fact, this was a trend predicted by Fredrickson, Levy, and Lees in their seminal papers [11].”
Background
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“Moreover, despite the marked reduction in LDL cholesterol induced by statins, a significant residual cardiovascular risk was reported in several major statin therapy trials [5].”
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Moreno‐Vedia, J., Llop, D., Rodríguez‐Calvo, R., Plana, N., Amigó, N., Rosales, R., Esteban, Y., Masana, L., Ibarretxe, D., & Girona, J. (2024) · European Journal of Clinical Investigation · doi:10.1111/eci.14132 · Cited by 19
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“disease, residual cardiovascular risk remains a major challenge (Sampson et al., 2012).”
Background
The role of triglycerides in the origin and progression of atherosclerosis
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Anti-Inflammatory Therapy in Coronary Artery Disease: Where Do We Stand?
Rakočević, J., Dobric, M. R., Labudović‐Borović, M., Milutinović, K., Milenkovic, S., & Tomasevic, M. V. (2023) · Reviews in Cardiovascular Medicine · doi:10.31083/j.rcm2401010 · Cited by 21
“Despite the large reduction in LDL-cholesterol, followed by the lower cardiovascular events, many patients are left with residual cardiovascular risk [2].”
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The role of remnant cholesterol in patients with ST-segment elevation myocardial infarction
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Translational atherosclerosis research: From experimental models to coronary artery disease in humans
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Upregulation of Circulating Cardiomyocyte-Enriched miR-1 and miR-133 Associate with the Risk of Coronary Artery Disease in Type 2 Diabetes Patients and Serve as Potential Biomarkers
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Oral PCSK9 Inhibitor Enlicitide Versus Oral Nonstatin Therapies
Catapano, A. L., Mikhailova, E., Navar, A. M., Banka, P., Corral, P., Saxena, M., Steg, P. G., Verma, S., Kordahi, A. Y., Mendizabal, G., et al. (2026) · JACC · doi:10.1016/j.jacc.2026.03.036 · Cited by 19
Non-HDL cholesterol paradox and effect of underlying malnutrition in patients with coronary artery disease: A 41,182 cohort study
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Thioridazine protects against disturbed flow-induced atherosclerosis by inhibiting RhoA/YAP-mediated endothelial inflammation
Jiang, M., Ding, H.-Y., Huang, Y., Cheng, C. K., Lau, C. W., Xia, Y. Y., Yao, X., Wang, L., & Huang, Y. (2023) · Acta Pharmacologica Sinica · doi:10.1038/s41401-023-01102-w · Cited by 18
“However, some patients on long-term statins still develop atherosclerotic cardiovascular disease and even acute myocardial infarction [24].”
Background
Safety and efficacy of a 48-week long-term ingestion of D-allulose in subjects with high LDL cholesterol levels
Tanaka, M., Kanasaki, A., Hayashi, N., Iida, T., & Murao, K. (2020) · Fundamental Toxicological Sciences · doi:10.2131/fts.7.15 · Cited by 19
Clinical- and cost-effectiveness of LDL particle-guided statin therapy: A simulation study
Folse, H. J., Goswami, D., Rengarajan, B., Budoff, M. J., & Kahn, R. (2014) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2014.06.027 · Cited by 19
Discordance analyses comparing LDL cholesterol, Non-HDL cholesterol, and apolipoprotein B for cardiovascular risk estimation
Johannesen, C. D. L., Mortensen, M. B., Nordestgaard, B. G., & Langsted, A. (2025) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2025.119139 · Cited by 22
Plasma lipoproteins in posttraumatic stress disorder patients compared to healthy controls and their associations with the HPA- and HPT-axis
de Vries, G., Mocking, R. J. T., Assies, J., Schene, A. H., & Olff, M. (2017) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2017.09.020 · Cited by 18
Efficacy and safety of proprotein convertase subtilisin/kexin 9 inhibitors in people with diabetes and dyslipidaemia
Dijk, W., & Cariou, B. (2019) · Diabetes Obesity and Metabolism · doi:10.1111/dom.13636 · Cited by 19
“8 mmol/L) might be beneficial, as no ‘threshold’ has yet been discovered where LDL-C lowering becomes futile.(11) A promising new avenue to lower residual cardiovascular risk in diabetic patients is the therapeutic inhibition of the proprotein convertase subtilisin/kexin 9 (PCSK9), which potently reduces plasma LDL-C…”
Background
Apolipoprotein E genetic variants interact with Mediterranean diet to modulate postprandial hypertriglyceridemia in coronary heart disease patients: CORDIOPREV study
Gómez-Delgado, F., Alcala-Diaz, J. F., Leon‐Acuña, A., López-Moreno, J., Delgado‐Lista, J., Gomez‐Marin, B., Roncero‐Ramos, I., Yubero‐Serrano, E. M., Rangel-Zúñiga, O. A., Vals‐Delgado, C., et al. (2019) · European Journal of Clinical Investigation · doi:10.1111/eci.13146 · Cited by 18
Nicotinamide Prevents Apolipoprotein B-Containing Lipoprotein Oxidation, Inflammation and Atherosclerosis in Apolipoprotein E-Deficient Mice
Méndez‐Lara, K. A., Letelier, N. A., Farré, N., Diarte‐Añazco, E. M. G., Nieto‐Nicolau, N., Rodríguez‐Millán, E., Santos, D., Pallarès, V., Escolá‐Gil, J. C., del Olmo, T. V., et al. (2020) · Antioxidants · doi:10.3390/antiox9111162 · Cited by 18
“Statins have been proven to be effective at reducing cardiovascular disease-related mortality and morbidity [5].”
Background
HDL-C, ApoA1 and VLDL-TG as biomarkers for the carotid plaque presence in patients with metabolic syndrome
Abi-Ayad, M., Abbou, A., Abi-Ayad, F. Z., Behadada, O., & Benyoucef, M. (2017) · Diabetes & Metabolic Syndrome Clinical Research & Reviews · doi:10.1016/j.dsx.2017.12.017 · Cited by 21
Safety and Efficacy of the Novel RNA Interference Therapies for Hypertriglyceridemia and Mixed Hyperlipidemia Management: A Systematic Review and Meta-analysis
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The performance of triglyceride to high-density lipoprotein cholesterol ratio in acute coronary syndromes using a diagnostic decision tree
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Fatty acid desaturase 2 is up-regulated by the treatment with statin through geranylgeranyl pyrophosphate-dependent Rho kinase pathway in HepG2 cells
Tanaka, S., Ishihara, N., Suzuki, S., Watanabe, Y., Nagayama, D., Yamaguchi, T., Ohira, M., Saiki, A., Tanaka, T., & Tatsuno, I. (2019) · Scientific Reports · doi:10.1038/s41598-019-46461-9 · Cited by 17
TAK1-AMPK Pathway in Macrophages Regulates Hypothyroid Atherosclerosis
Yang, Y., Jia, Y., Ning, Y., Wen, W., Qin, Y., Zhang, H., Du, Y., Li, L., Jiao, X., Yang, Y., et al. (2020) · Cardiovascular Drugs and Therapy · doi:10.1007/s10557-020-06996-w · Cited by 18
The U-shaped association of non-high-density lipoprotein cholesterol with all-cause and cardiovascular mortality in general adult population
Huang, Y., Yan, M. Q., Zhou, D., Chen, C. L., & Feng, Y. (2023) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2023.1065750 · Cited by 17
Effects of Xuezhitong in Patients with Hypertriglyceridemia: a Multicentre, Randomized, Double-Blind, Double Simulation, Positive Drug and Placebo Parallel Control Study
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The impact of the cumulative burden of LDL-c and hs-CRP on cardiovascular risk: a prospective, population-based study
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“However, although therapeutic targets for LDL-c can be reached, residual risk for CVD remains a challenge [6], possibly due to inflammation during atherosclerosis.”
Background
Local Inhibition of Macrophage and Smooth Muscle Cell Proliferation to Suppress Plaque Progression
Sukhovershin, R. A., Furman, N. E. T., Tasciotti, E., & Trachtenberg, B. H. (2016) · Methodist DeBakey Cardiovascular Journal · doi:10.14797/mdcj-12-3-141 · Cited by 17
Anionic nanoliposomes reduced atherosclerosis progression in Low Density Lipoprotein Receptor ( LDLR ) deficient mice fed a high fat diet
Krishna, S. M., Moxon, J. V., Jose, R. J., Li, J., Sahebkar, A., Jaafari, M. R., Hatamipour, M., Liu, D., & Golledge, J. (2018) · Journal of Cellular Physiology · doi:10.1002/jcp.26610 · Cited by 17
Experimental therapies targeting apolipoprotein C-III for the treatment of hyperlipidemia – spotlight on volanesorsen
Milonas, D., & Τζιόμαλος, Κ. (2019) · Expert Opinion on Investigational Drugs · doi:10.1080/13543784.2019.1582028 · Cited by 17
Proprotein convertase subtilisin/kexin type 9 enzyme inhibitors: An emerging new therapeutic option for the treatment of dyslipidemia
Mazhar, F., & Haider, N. (2016) · Journal of Pharmacology and Pharmacotherapeutics · doi:10.4103/0976-500x.195906 · Cited by 16
“The other 70% which is usually referred as “residual risk,”[5,6] perhaps it would be more appropriate to call it “persistent risk.”
Background
Atherogenic dyslipidaemic profiles associated with the development of Type 2 diabetes: a 3.1‐year longitudinal study
Hwang, Y., Ahn, H.-C., Yu, S. ‐., Park, S. ‐., & Park, C. ‐. (2013) · Diabetic Medicine · doi:10.1111/dme.12278 · Cited by 16
Atorvastatin increases Fads1, Fads2 and Elovl5 gene expression via the geranylgeranyl pyrophosphate-dependent Rho kinase pathway in 3T3-L1 cells
Ishihara, N., Suzuki, S., Tanaka, S., Watanabe, Y., Nagayama, D., Saiki, A., Tanaka, T., & Tatsuno, I. (2017) · Molecular Medicine Reports · doi:10.3892/mmr.2017.7141 · Cited by 16
“Despite the significant LDL-C-lowering effects of statins, substantial residual cardiovascular risk remains (11), and numerous Atorvastatin increases Fads1, Fads2 and Elovl5 gene expression via the geranylgeranyl pyrophosphate‐dependent Rho kinase pathway in 3T3‐L1 cells”
Background
Phospholipid packing defects and oxysterols in atherosclerosis: Dietary prevention and the French paradox
Brown, R. B. (2019) · Biochimie · doi:10.1016/j.biochi.2019.09.020 · Cited by 18
Prevalence and clinical characteristics of patients with hsCRP testing and test-confirmed systemic inflammation among individuals with atherosclerotic cardiovascular disease with or without chronic kidney disease in the United States (PLUTUS)
Lv, L., Rajpura, J. R., Liu, M., Strum, M., Chastek, B. J., Johnson, J., & Gluckman, T. J. (2025) · American Journal of Preventive Cardiology · doi:10.1016/j.ajpc.2025.100950 · Cited by 15
Diet and Nutraceutical Supplementation in Dyslipidemic Patients: First Results of an Italian Single Center Real-World Retrospective Analysis
Pasta, A., Formisano, E., Cremonini, A. L., Maganza, E., Parodi, E., Piras, S., & Pisciotta, L. (2020) · Nutrients · doi:10.3390/nu12072056 · Cited by 16
“To date the pharmacological treatment of hyperlipidemias involves various types of drugs: statins (inhibitors of cholesterol synthesis) have fully demonstrated efficacy in improving the lipid profile and reducing cardiovascular risk [7], however, LDL‐C serum levels achieved with statins do not fully reduce the risk of…”
Background
Association of remnant cholesterol and lipid parameters with new-onset carotid plaque in Chinese population
Liu, B., Fan, F., Zheng, B., Yang, Y., Jia, J., Sun, P., Jiang, Y., Li, K., Liu, J., Chen, C., et al. (2022) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2022.903390 · Cited by 14
Genetics of Triglyceride-Rich Lipoproteins Guide Identification of Pharmacotherapy for Cardiovascular Risk Reduction
Shaik, A., & Rosenson, R. S. (2021) · Cardiovascular Drugs and Therapy · doi:10.1007/s10557-021-07168-0 · Cited by 15
Combination therapy with pemafibrate (K-877) and pitavastatin improves vascular endothelial dysfunction in dahl/salt-sensitive rats fed a high-salt and high-fat diet
Yoshida, M., Nakamura, K., Miyoshi, T., Yoshida, M., Kondo, M., Akazawa, K., Kimura, T., Ohtsuka, H., Ohno, Y., Miura, D., et al. (2020) · Cardiovascular Diabetology · doi:10.1186/s12933-020-01132-2 · Cited by 16
Scavenging dicarbonyls with 5′-O-pentyl-pyridoxamine increases HDL net cholesterol efflux capacity and attenuates atherosclerosis and insulin resistance
Huang, J., Tao, H., Yancey, P. G., Leuthner, Z., Zhang, L., Jung, J., Zhang, Y., Ding, L., Amarnath, V., Liu, D., et al. (2022) · Molecular Metabolism · doi:10.1016/j.molmet.2022.101651 · Cited by 15
“Although clinical trials of lowering LDL-C have consistently been demonstrated to reduce cardiovascular events, a considerable residual risk of cardiovascular disease still exists, which may be due in part to inflammation [1-3].”
BackgroundSelf-citation
Simultaneously blocking ANGPTL3 and CD47 prevents the progression of atherosclerosis through regulating lipid metabolism, macrophagic efferocytosis and lipid peroxidation
Hu, X., Nan, Y., Zhang, Y., Fan, J., Wang, H., Bai, Y., Zhang, Y., Zhang, X., Zhu, Z., Cao, Z., et al. (2024) · Pharmacological Research · doi:10.1016/j.phrs.2024.107486 · Cited by 16
Taoren Honghua Decoction alleviates atherosclerosis by inducing autophagy and inhibiting the PI3K-AKT signaling pathway to regulate cholesterol efflux and inflammatory responses
Chang, X., Feng, X., Li, S., Wang, J., Liu, P., & Wang, Y. (2024) · International Immunopharmacology · doi:10.1016/j.intimp.2024.113629 · Cited by 14
Changes in lipoprotein particle subclasses, standard lipids, and apolipoproteins after supplementation with n-3 or n-6 PUFAs in abdominal obesity: A randomized double-blind crossover study
Grytten, E., Laupsa‐Borge, J., Bohov, P., Bjørndal, B., Strand, E., Skorve, J., Nordrehaug, J. E., Berge, R. K., Rostrup, E., Mellgren, G., et al. (2021) · Clinical Nutrition · doi:10.1016/j.clnu.2021.03.040 · Cited by 14
Anti-inflammatory, but not lipid-lowering, activity of hepatocyte PPARα improves atherosclerosis in Ldlr- deficient mice
Henry, D., Baugé, E., Hennuyer, N., Ory, K., Derudas, B., Vallez, E., Deprince, A., Lefèbvre, P., Haas, J. T., Staels, B., et al. (2025) · Science Translational Medicine · doi:10.1126/scitranslmed.adj8192 · Cited by 14
LDL atherogenicity determined by size, density, oxidation, apolipoprotein(a), and electronegativity: an updated review
Akyol, Ö., Chiang, H., Burns, A. R., Yang, C.-Y., Woodside, D. G., Sawamura, T., Sánchez‐Quesada, J. L., Gotto, A. M., & Chen, C. (2025) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2025.1649759 · Cited by 14
Evinacumab Reduces Triglyceride-Rich Lipoproteins in Patients with Hyperlipidemia: A Post-Hoc Analysis of Three Randomized Clinical Trials
Rosenson, R. S., Rader, D. J., Ali, S., Banerjee, P., McGinniss, J., & Pordy, R. (2025) · Cardiovascular Drugs and Therapy · doi:10.1007/s10557-024-07567-z · Cited by 13
Traditional Chinese medicine and plant-derived natural products in regulating triglyceride metabolism: Mechanisms and therapeutic potential
Zhou, J., & Wang, X. (2024) · Pharmacological Research · doi:10.1016/j.phrs.2024.107387 · Cited by 13
Mendelian Randomization Studies in Atherosclerotic Cardiovascular Diseases
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“37 This notion emphasizes the concept of residual risk and highlights the persistence of clinical events despite intensive lipid-lowering therapies.”
Background
Self‐Assembled Peptide Amphiphile Nanofibers for Controlled Therapeutic Delivery to the Atherosclerotic Niche
Peters, E. B., Karver, M. R., Sun, K., Gillis, D. C., Biswas, S., Clemons, T. D., He, W., Tsihlis, N. D., Stupp, S. I., & Kibbe, M. R. (2021) · Advanced Therapeutics · doi:10.1002/adtp.202100103 · Cited by 13
Is sdLDL a valuable screening tool for cardiovascular disease in patients with metabolic syndrome?
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“Also, according to a meta-analysis of twelve RCTs, a residual risk of major cardiovascular events was demonstrated despite usage of hypolipemic agents (statins).(23) This raises the question about the role of fibrates which target specifically the sdLDL.”
Method
Testing Genetic Pleiotropy with GWAS Summary Statistics for Marginal and Conditional Analyses
Deng, Y., & Pan, W. (2017) · Genetics · doi:10.1534/genetics.117.300347 · Cited by 13
“…the primary treatment target to reduce cardiovascular disease (CVD) risk, it has been shown that high triglyceride (TG) level is a possible independent risk factor for CVD, even in patients with treatment-controlled LDL levels (Boekholdt et al. 2012; Sampson et al. 2012; Do et al. 2013; Toth 2016).”
Background

Authors: Sampson, U. K., Fazio, S., & Linton, M. F.
Affiliations: Vanderbilt University Medical Center (US)
Corresponding author: Linton, MacRae F.
ORCID: Fazio, Sergio
Linton, MacRae F.
Venue: Current Atherosclerosis Reports
Publisher: Springer Science and Business Media LLC
Published: 2011-11-19
Volume: 14
Issue: 1
Pages: 1-10
ISSN: 1523-3804 (ISSN-L)
1534-6242
DOI: 10.1007/s11883-011-0219-7
PMC: PMC3697085
OpenAlex: W2079979713
Cited by: 439
References: 117
Citations by year: 2026: 37 · 2025: 36 · 2024: 38 · 2023: 50 · 2022: 43 · 2021: 36 · 2020: 34 · 2019: 36 · 2018: 33 · 2017: 25 · 2016: 19 · 2015: 18 · 2014: 15 · 2013: 11 · 2012: 7
FWCI: 1.91
Type: journal article
Language: en
Open access: green
europepmc.org
Licence: www.springer.com/tdm (tdm)
Locations: Current Atherosclerosis Reports (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Heart, Lung, and Blood Institute (R01HL065709, R01HL086988, HL086988, HL105375, HL65709, R01HL105375)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
Keywords: residual cardiovascular risk, LDL cholesterol lowering, statins, HDL cholesterol, triglycerides, fenofibrate, torcetrapib, nicotinic acid, AIM-HIGH trial, ILLUMINATE trial, diabetes mellitus, metabolic syndrome, lifestyle modification, lipid therapy
MeSH terms: Cardiovascular Diseases, Humans, Life Style, Cholesterol, LDL, Morbidity, Risk Factors, Risk Assessment, Hydroxymethylglutaryl-CoA Reductase Inhibitors

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Residual Cardiovascular Risk Despite Optimal LDL Cholesterol Reduction with Statins: The Evidence, Etiology, and Therapeutic Challenges

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