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Cardiology

Lipid Disorders   

Questions discussed in this category

When do you think physicians should seriously consider prescribing PCSK9 inhibitors for the prevention of heart attack and stroke in people with ASCVD or diabetes, based on the results of the VESALIUS-CV trial?
Bohula et al., PMID 41211925
1 Answer available
Would you consider transitioning patients older than 75 years of age with coronary disease from statins and/or other lipid-lowering agents to PCSK9 inhibitors given concerns for polypharmacy, provided their LDL levels remain at or below goal?
2 Answers available
Would you consider PCSK9 inhibitors for patients with elevated coronary calcium score or coronary calcification for primary prevention in lieu of statins/ezetimibe and/or bempedoic acid?
2 Answers available
What patient factors do you consider when selecting between a small interfering RNA, like inclisiran, and PCSK9 inhibitors in patients with recent acute coronary syndrome?
2 Answers available
What should the LDL target be in patients with prediabetes and high lipoprotein (a) with family history of coronary artery disease?
6 Answers available
Do you start a statin concurrently with icosapent ethyl for patients with moderate hypertriglyceridemia and high ASCVD risk, or do you prefer to start a statin alone and monitor triglyceride levels?
Moderate hypertriglyceridemia is defined here as a triglyceride level of 150-499 mg/dL.
2 Answers available
What is your approach to the management of incidentally elevated HDL levels in isolation and is there any utility for further ASCVD risk stratification and/or genetic testing for lipid disorders? 
1 Answer available
How do you counsel patients with metabolic syndrome who decline statin therapy and have low coronary calcium scores regarding their long-term CVD risk?
3 Answers available
In ischemic stroke patients with low LDL levels (<30-50 mg/dl), would you consider lowering LDL levels to lower values without concern for any side effects?
How would you adjust statin therapy in these patients?
5 Answers available
For a patient with known CAD and low baseline HDL, would a PCSK9 inhibitor be a better option than a statin, given concerns for paradoxical lowering of HDL levels with statin therapy that we can encounter in the outpatient clinical setting? 
5 Answers available
What is the clinical significance of a paradoxical decrease in HDL cholesterol after starting statin therapy?
2 Answers available
How often do you recommend performing an advanced lipid panel for monitoring of lipid lowering therapy?
4 Answers available
Under what clinical circumstances, if any, would you prescribe fenofibrate along with statin therapy?
2 Answers available
Is there any difference in the cardiovascular risk reduction profile of brand name Vascepa versus generic icosapent ethyl for patients with hypertriglyceridemia?
1 Answer available
What other considerations for hyperlipidemia management would you have for a patient with multiple prior PCIs whose LDL remains above goal on high intensity statin, ezetimibe, and evolocumab, assuming the patient is compliant with medications?
3 Answers available
Would you consider adding niacin to the lipid lowering regimen in statin-intolerant patients who cannot afford PCSK9i or bempedoic acid?
Ferrell et al., PMID 38448791
6 Answers available
Will TRYNGOLZA (olezarsen), recently approved for familial chylomicronemia syndrome, also lower triglycerides due to other genetic causes of hypertriglyceridemia?
2 Answers available
Is moderate-intensity statin plus ezetimibe just as effective as high-intensity statin monotherapy in preventing major cardiovascular events?
4 Answers available
Would you recommend statin initiation in a young adult patient (age < 40) with type 1 diabetes mellitus and LDL cholesterol levels greater than 100 without any cardiovascular risk factors?
1 Answer available
Do you recommend adding low-dose Aspirin for primary prevention in patients with Type 2 Diabetes on Eliquis for another indication?
1 Answer available
Should all kidney transplant patients be started on statin therapy post operatively given their increased risk of CVD?
At what doses do you start? and how do you titrate therapy?
1 Answer available
Do you recommend the use of bempedoic acid (Nexletol) for treatment of hyperlipidemia in patients with elevated baseline uric acid levels?
Should uric acid levels be monitored regularly while on therapy?
1 Answer available
Should low-intensity statins be favored to minimize the risk of diabetes onset while still offering cardiovascular benefit for patients with prediabetes where a statin is indicated?
Cholesterol Treatment Trialists' (CTT) Collaboration
2 Answers available
When and for whom should we consider adding bempedoic acid to the lipid lowering regimen?
3 Answers available
How do you counsel patients with non-statin associated inflammatory myopathies about statin use?
1 Answer available


Papers discussed in this category

Lancet (London, England), 2023 Mar 06
Inflammation and cholesterol as predictors of cardiovascular events among patients receiving statin therapy: a collaborative analysis of three randomised trials.
Curr Rheumatol Rep, 2020 Aug 26
Lipid-lowering Therapies in Myositis.
The American journal of cardiology, 2004-02-01
Safety and tolerability of simvastatin plus niacin in patients with coronary artery disease and low high-density lipoprotein cholesterol (The HDL Atherosclerosis Treatment Study).
Nature medicine, 2024 Feb 19
A terminal metabolite of niacin promotes vascular inflammation and contributes to cardiovascular disease risk.
Journal of clinical lipidology, 2024 Mar 29
A focused update to the 2019 NLA scientific statement on use of lipoprotein(a) in clinical practice.
Journal of the American College of Cardiology, 1986-12
Fifteen year mortality in Coronary Drug Project patients: long-term benefit with niacin.
The New England journal of medicine, 2011-12-15
Niacin in patients with low HDL cholesterol levels receiving intensive statin therapy.
Current opinion in lipidology, 2007 Aug
Niacin in cardiovascular prevention: mechanisms, efficacy, and safety.
The American journal of cardiology, 2005 Jun 01
Influence of extended-release nicotinic acid on nonesterified fatty acid flux in the metabolic syndrome with atherogenic dyslipidemia.
Trials, 2018 Mar 05
Improved adherence adjustment in the Coronary Drug Project.
The New England journal of medicine, 2014 Jul 17
Effects of extended-release niacin with laropiprant in high-risk patients.
JAMA, 1975 Jan 27
Clofibrate and niacin in coronary heart disease.
Stroke, 2007-12
Effects of intense low-density lipoprotein cholesterol reduction in patients with stroke or transient ischemic attack: the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial.
The New England journal of medicine, 2006 Aug 10
High-dose atorvastatin after stroke or transient ischemic attack.
European heart journal, 2020 Jan 01
2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk.
Journal of the American Heart Association, 2023 Sep 08
Statin Treatment in Patients With Stroke With Low-Density Lipoprotein Cholesterol Levels Below 70 mg/dL.
The New England journal of medicine, 2011-12-01
Effect of two intensive statin regimens on progression of coronary disease.
Circulation, 2019-06-18
2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.
The New England journal of medicine, 2019-01-03
Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia.
The New England journal of medicine, 2024 Apr 07
Olezarsen for Hypertriglyceridemia in Patients at High Cardiovascular Risk.
Journal of clinical lipidology, 2022 Sep 11
Assessment and management of statin-associated muscle symptoms (SAMS): A clinical perspective from the National Lipid Association.
Ophthalmology, 2014-12
The effects of medical management on the progression of diabetic retinopathy in persons with type 2 diabetes: the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Eye Study.
Lancet (London, England), 2007 Nov 07
Effect of fenofibrate on the need for laser treatment for diabetic retinopathy (FIELD study): a randomised controlled trial.
NEJM evidence, 2024 Jun 21
Effect of Fenofibrate on Progression of Diabetic Retinopathy.
The New England journal of medicine, 2025 Nov 08
Evolocumab in Patients without a Previous Myocardial Infarction or Stroke.
Journal of the American College of Cardiology, 2022 Mar 01
Independent Association of Lipoprotein(a) and Coronary Artery Calcification With Atherosclerotic Cardiovascular Risk.

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