Role of Non-Statins, LDL-C Thresholds, and Special Population Considerations: A Look at the Updated 2016 ACC Consensus Committee Recommendations

Current Atherosclerosis Reports
Bhavin B Adhyaru, Terry A Jacobson

Abstract

The 2013 ACC/AHA Cholesterol guidelines was a major paradigm shift in the management and treatment of dyslipidemia. The new guidelines outlined "statin benefit groups," highlighted weighing the benefit versus risks of statin therapy ("net benefit"), and discussed the importance of shared decision making between patients and providers in primary prevention. While there was widespread agreement on the main groups benefiting from statin therapy, there was significant controversy regarding LDL-C goals and thresholds, the role of non-statin therapy, and the use of statins in specific populations. The goal of this review is to understand the rationale for the updated 2016 ACC Expert Consensus on Non-Statins and to contrast it with the 2015 NLA Recommendations on the Management of Dyslipidemia. The findings of the ACC Expert Consensus Panel were largely influenced by the results of several new clinical trials using non-statin therapy in combination with moderate to high intensity statin therapy. The IMPROVE-IT trial demonstrated that ezetimibe on top of statin therapy lowered ASCVD risk in patients with acute coronary syndromes whose LDL was driven below the previous LDL-C target of <70 mg/dL. In addition, preliminary data assessing t...Continue Reading

References

Dec 1, 1986·Journal of the American College of Cardiology·P L CannerW Friedewald
May 23, 2001·JAMA : the Journal of the American Medical Association·UNKNOWN Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults
Jul 22, 2005·The New England Journal of Medicine·Christoph WannerUNKNOWN German Diabetes and Dialysis Study Investigators
Nov 7, 2007·The New England Journal of Medicine·John KjekshusUNKNOWN CORONA Group
Nov 11, 2008·The New England Journal of Medicine·Paul M RidkerUNKNOWN JUPITER Study Group
Apr 1, 2009·The New England Journal of Medicine·Bengt C FellströmUNKNOWN AURORA Study Group
Mar 17, 2010·The New England Journal of Medicine·Henry N GinsbergRobert P Byington
Oct 11, 2011·Journal of Cardiovascular Pharmacology·Saurabh AggarwalRohit R Arora
Nov 17, 2011·The New England Journal of Medicine·William E BodenWilliam Weintraub
Mar 19, 2013·Circulation Journal : Official Journal of the Japanese Circulation Society·Hiroyuki TakanoUNKNOWN PEARL Study Investigators
Jul 12, 2014·The New England Journal of Medicine·Martin J LandrayJane Armitage
Mar 17, 2015·The New England Journal of Medicine·Jennifer G RobinsonUNKNOWN ODYSSEY LONG TERM Investigators
Mar 17, 2015·The New England Journal of Medicine·Marc S SabatineUNKNOWN Open-Label Study of Long-Term Evaluation against LDL Cholesterol (OSLER) Investigators
Apr 18, 2015·European Heart Journal·John Kjekshus
Apr 26, 2015·Journal of Clinical Lipidology·Terry A JacobsonW Virgil Brown
May 26, 2015·Current Atherosclerosis Reports·Vijay G Bhoj, Bruce S Sachais
Jun 4, 2015·The New England Journal of Medicine·Christopher P CannonUNKNOWN IMPROVE-IT Investigators
Oct 30, 2015·Circulation·Samuel S GiddingUNKNOWN American Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee of the Council on Cardiovascula
Mar 19, 2016·Arteriosclerosis, Thrombosis, and Vascular Biology·Jennifer G Robinson, Kausik Ray
Mar 18, 2017·The New England Journal of Medicine·Marc S SabatineUNKNOWN FOURIER Steering Committee and Investigators

❮ Previous
Next ❯

Citations

Mar 9, 2018·Current Atherosclerosis Reports·Cori RussellDouglas Jacoby
Oct 31, 2018·Nature Reviews. Cardiology·Bhavin B Adhyaru, Terry A Jacobson
May 23, 2019·Current Cardiology Reviews·Romeo-Gabriel Mihăilă
Jul 18, 2019·High Blood Pressure & Cardiovascular Prevention : the Official Journal of the Italian Society of Hypertension·Walter MassonJuan Patricio Nogueira
Sep 16, 2019·Biomedicine & Pharmacotherapy = Biomédecine & Pharmacothérapie·Yeqing FangHongcheng Fang
May 25, 2021·The International Journal of Angiology : Official Publication of the International College of Angiology, Inc·Qais RadaidehRayan Jo Rachwan

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiovascular Disease Pathophysiology

Cardiovascular disease involves several different processes that contribute to the pathological mechanism, including hyperglycemia, inflammation, atherosclerosis, hypertension and more. Vasculature stability plays a critical role in the development of the disease. Discover the latest research on cardiovascular disease pathophysiology here.

ApoE, Lipids & Cholesterol

Serum cholesterol, triglycerides, apolipoprotein B (APOB)-containing lipoproteins (very low-density lipoprotein (VLDL), immediate-density lipoprotein (IDL), and low-density lipoprotein (LDL), lipoprotein A (LPA)) and the total cholesterol/high-density lipoprotein (HDL) cholesterol ratio are all connected in diseases. Here is the latest research.