There has been great confusion in field of lipid management as to whether or not LDL targets should be used to guide therapy in patients with hypercholesterolemia. In this Clinical Coffee Break, Dr. Christopher Cannon, professor of medicine at Harvard Medical School, will discuss why providers should consider using LDL targets to guide lipid management. He will review new evidence in support of using specific LDL targets for patients at low-, moderate- and high-cardiovascular risk. Additionally, he will discuss how to identify patients who are not achieving LDL-C control and who may be candidates for PCSK9 inhibitor therapy.
Clinicians face challenging questions about the evolution and clinical implementation of recently updated cholesterol lowering guidelines and the apparent abandonment of LDL-C goals for treatment. Dr. Evan A Stein MD, PhD, Director Emeritus, Metabolic & Atherosclerosis Research Center in Cincinnati, responds to questions regarding updated cholesterol lowering guidelines, the relationship between LDL-C and CVD risk reduction, the unmet need for additional LDL-C lowering medications and the potential for PCSK9 monoclonal antibodies to address the greatest unmet need -- patients unable to tolerate statins or effective doses of statins and patients with more severe elevations of LDL-C.
Intolerance to statins is seen frequently by primary care physicians in clinical practice. Most common adverse events reported by the patients are muscle weakness and increased hepatic enzymes. These side effects of statin therapy lead to reduced adherence and, ultimately, reduced cardiovascular benefit. This activity discusses the lifestyle, diet, and pharmacologic options available to the statin intolerant patient to manage their cardiovascular health in a primary care setting.
Three complex lipid cases will be presented in this activity. The cases will address risk assessment for cardiovascular disease and treatment options. The first case will be complicated by muscle side effects of the statin medication, leading to a discussion of statin dosing options. The second case will present with a mixed hyperlipidemia and discuss the use of combination therapy and the side effects that can occur due to drug–drug interactions. The third case will present with markedly high triglycerides, and dietary management will be discussed.
Advances in screening patients for cardiovascular risk using risk calculators, biomarkers and other tests have the potential to transform the field of preventive cardiovascular medicine. Dr. James de Lemos reviews the latest evidence on the use of screening to risk stratify patients and predict which patients could most benefit from early interventions.
Learn the best practices to screen for and manage hypercholesterolemia and other lipid disorders in your clinic. Get updates on the latest drugs available to combat these conditions, and become familiar with the current practice guidelines for statin use in patients.
In this case presentation, Dr. Gluckman discusses a patient with hypercholesterolemia and reviews a step-wise, evidence-based strategy for incorporating non-statin therapy, such as PCSK9 inhibitors, for lowering low-density lipoprotein (LDL)-cholesterol.