RT Book, Section
A1 Dixon, Dave L.
A1 Riche, Daniel M.
A1 Kelly, Michael S.
A2 DiPiro, Joseph T.
A2 Yee, Gary C.
A2 Michael Posey, L.
A2 Haines, Stuart T.
A2 Nolin, Thomas D.
A2 Ellingrod, Vicki L.
SR Print(0)
ID 1191226499
T1 Dyslipidemia
T2 DiPiro: Pharmacotherapy A Pathophysiologic Approach, 12e
YR 2021
FD 2021
PB McGraw Hill
PP New York, NY
SN 9781260116564
LK accesspharmacy.mhmedical.com/content.aspx?aid=1191226499
RD 2022/07/01
AB KEY  CONCEPTS  Lipid  abnormalities  increase  the  risk  of  atherosclerotic  cardiovascular  disease  (ASCVD)  which  includes  ischemic  coronary  heart  disease,  ischemic  stroke,  and  peripheral  arterial  disease.  Low-density-lipoprotein  cholesterol  (LDL-C)  is  the  primary  target  to  reduce  the  risk  of  ASCVD  events.  Genetic  abnormalities  and  environmental  factors  are  involved  in  the  development  of  dyslipidemia.  Therapeutic  lifestyle  change  is  the  first-line  therapy  for  any  lipoprotein  disorder.  If  therapeutic  lifestyle  changes  are  insufficient,  lipid-lowering  agents  should  be  chosen  based  on  which  lipid  is  at  an  undesirable  level  and  the  degree  to  which  it  is  expected  to  increase  the  risk  of  ASCVD.  Statins  are  the  drug  of  choice  for  dyslipidemia  because  they  significantly  lower  LDL-C  and  the  risk  of  ASCVD  events,  and  are  generally  well  tolerated.  If  statin  monotherapy  is  insufficient,  patients  may  be  treated  with  evidence-based  combination  therapy  but  should  be  monitored  closely  for  drug-drug  interactions.  Reducing  total  cholesterol  and  LDL-C  reduces  CHD  and  total  mortality.  Lipid-lowering  therapies  that  reduce  ASCVD  event  rates  are  cost-effective.  Several  novel  medications  including  antisense  oligonucleotide  inhibitors  of  apoB,  microsomal  triglyceride  transport  protein  inhibitors,  adenosine  triphosphate-citrate  lyase  (ACL)  inhibitors,  and  proprotein  convertase  subtilisin/kexin  type  9  (PCSK9)  inhibitors  can  be  used  as  add-on  therapy  or  in  lieu  of  statin  therapy  in  select  high-risk  populations.