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Cited by 39Lipoproteins and Cardiovascular HealthCholesterol and Lipid MetabolismLipid metabolism and disorders

Novel and Emerging LDL-C Lowering Strategies: A New Era of Dyslipidemia Management

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Agnello, Federica, Ingala, Salvatore, Laterra, Giulia, Scalia, Lorenzo, Barbanti, Marco·2024·Journal of Clinical Medicine
DOI 10.3390/jcm13051251PMC PMC10931739
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Abstract

Atherosclerotic cardiovascular disease (ASCVD) represents a major global health challenge, significantly contributing to mortality rates. This chronic inflammatory condition affecting blood vessels is intricately linked to hypercholesterolemia, with elevated levels of low-density lipoprotein cholesterol (LDL-C) recognized as a central and modifiable risk factor. The effectiveness of lipid-lowering therapy (LLT) in mitigating ASCVD risk is well established, with studies revealing a substantial reduction in major ischemic events correlating with LDL-C reduction. While statins, often combined with ezetimibe, remain fundamental in dyslipidemia management, a significant proportion of patients on statin therapy continue to experience cardiovascular events. Recent pharmacological advancements, driven by a deeper understanding of atherogenesis, have unveiled novel therapeutic targets and potent drugs. Notably, agents like bempedoic acid and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors (evolocumab, alirocumab, inclisiran) have emerged as effective options to intensify LLT and achieve LDL-C goals, addressing limitations associated with statins, such as myopathy. Molecular insights into alternative pathways have spurred the investigation of emerging agents, offering promising perspectives for novel medications with efficacy comparable to established treatments, associated with advantages in cost and administration. This review provides a comprehensive overview of the evolving landscape of lipid-lowering strategies, highlighting the progress made in addressing ASCVD risk and the potential of upcoming therapies to further optimize cardiovascular prevention.

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  • Long-term studies have established inclisiran as a fundamental drug for lipid management due to its ability to ensure high patient adherence and long-term LDL-C control.

    “Long-term studies have established inclisiran as a fundamental drug for lipid management due to its ability to ensure high patient adherence and long-term LDL-C control [47, 48].”

    From Inclisiran SiRNA therapy for durable LDL-C reduction: a systematic review and meta-analysis highlighting a breakthrough in long-term cardiovascular risk management (2026) · cites this paper as [48]

    Section 4.2 reports sustained LDL-C reductions in a four-year inclisiran extension study, supporting the long-term control claim. But section 6 describes improved medication adherence as a potential advantage of twice-yearly dosing, not an established ability to ensure high adherence; the paper also does not establish inclisiran as a fundamental drug. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

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Authors
Agnello, F., Ingala, S., Laterra, G., Scalia, L., & Barbanti, M.
Affiliations
  • Division of Cardiology, Ospedale Umberto I, ASP 4 di Enna, 94100 Enna, Italy
  • Università degli Studi di Enna Kore (IT)
Corresponding author
Barbanti, Marco
ORCID
Venue
Journal of Clinical Medicine
Publisher
MDPI AG
Published
2024-02-22
Volume
13
Issue
5
Pages
1251
ISSN
2077-0383 (ISSN-L)
DOI
10.3390/jcm13051251
PMC
PMC10931739
OpenAlex
W4392040213
Cited by
39
References
93
Citations by year
2026: 20 · 2025: 14 · 2024: 5
FWCI
4.32
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Clinical Medicine (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Surgery › Cholesterol and Lipid Metabolism
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
Keywords
LDL cholesterol lowering, dyslipidemia management, atherosclerotic cardiovascular disease, hypercholesterolemia, lipid-lowering therapy, statins, ezetimibe, bempedoic acid, PCSK9 inhibitors, evolocumab, alirocumab, inclisiran, statin-induced myopathy, cardiovascular disease prevention

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