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Benefits and drawbacks of statins and non-statin lipid lowering agents in carotid artery disease

Data de publicação: Data Ahead of Print:

Autores da FMUP

  • Armando Amilcar Pires Mansilha Rodrigues De Almeida

    Autor

Participantes de fora da FMUP

  • Paraskevas, KI
  • Gloviczki, P
  • Antignani, PL
  • Comerota, AJ
  • Dardik, A
  • Davies, AH
  • Eckstein, HH
  • Faggioli, G
  • Fernandes, JFE
  • Fraedrich, G
  • Geroulakos, G
  • Golledge, J
  • Gupta, A
  • Gurevich, VS
  • Jawien, A
  • Jezovnik, MK
  • Kakkos, SK
  • Knoflach, M
  • Lanza, G
  • Liapis, CD
  • Loftus, IM
  • Nicolaides, AN
  • Pini, R
  • Poredos, P
  • Proczka, RM
  • Ricco, JB
  • Rundek, T
  • Saba, L
  • Schlachetzki, F
  • Silvestrini, M
  • Spinelli, F
  • Stilo, F
  • Suri, JS
  • Svetlikov, A
  • Zeebregts, CJ
  • Chaturvedi, S
  • Veith, FJ
  • Mikhailidis, DP

Unidades de investigação

Abstract

International guidelines strongly recommend statins alone or in combination with other lipid-lowering agents to lower low-density lipoprotein cholesterol (LDL-C) levels for patients with asymptomatic/symptomatic carotid stenosis (AsxCS/SCS). Lowering LDL-C levels is associated with significant reductions in transient ischemic attack, stroke, cardiovascular (CV) event and death rates. The aim of this multi-disciplinary overview is to summarize the benefits and risks associated with lowering LDL-C with statins or non-statin medications for Asx/SCS patients. The cerebrovascular and CV beneficial effects associated with statins, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors and other non-statin lipid-lowering agents (e.g. fibrates, ezetimibe) are reviewed. The use of statins and PCSK9 inhibitors is associated with several beneficial effects for Asx/SCS patients, including carotid plaque stabilization and reduction of stroke rates. Ezetimibe and fibrates are associated with smaller reductions in stroke rates. The side-effects resulting from statin and PCSK9 inhibitor use are also highlighted. The benefits associated with lowering LDL-C with statins or non-statin lipid lowering agents (e.g. PCSK9 inhibi-tors) outweigh the risks and potential side-effects. Irrespective of their LDL-C levels, all Asx/SCS patients should receive high-dose statin treatment +/- ezetimibe or PCSK9 inhibitors for reduction not only of LDL-C levels, but also of stroke, cardiovascular mortality and coronary event rates.(c) 2022 Elsevier Inc. All rights reserved.

Copyright © 2022 Elsevier Inc. All rights reserved.

Dados da publicação

ISSN/ISSNe:
1873-1740, 0033-0620

Progress in Cardiovascular Diseases  W.B. Saunders Ltd

Tipo:
Review
Páginas:
41-47
Link para outro recurso:
www.scopus.com

Citações Recebidas na Web of Science: 9

Citações Recebidas na Scopus: 18

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Keywords

  • Carotid artery stenosis; Best medical treatment; Carotid endarterectomy; Carotid artery stenting; Statins; Proprotein convertase subtilisin; kexin type 9 (PCSK9) inhibitors

Campos de estudo

Proyectos asociados

Endovascular Treatment of Aortic Arch Aneurysms

Investigador Principal: Armando Amilcar Pires Mansilha Rodrigues de Almeida

Estudo Clínico Académico (Aneurysms) . 2020

The role of infrared thermography in predicting diabetic foot outcomes

Investigador Principal: Armando Amilcar Pires Mansilha Rodrigues de Almeida

Estudo Clínico Académico (diabetic foot) . 2021

Endovascular solutions for type IA endoleak after endovascular aneurysm repair

Investigador Principal: Armando Amilcar Pires Mansilha Rodrigues de Almeida

Estudo Clínico Académico . 2021

Intermittent Claudication: Importance of Supervised Exercise Programme

Investigador Principal: Armando Amilcar Pires Mansilha Rodrigues de Almeida

Estudo Clínico Académico . 2021

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