When to lower triglycerides?

Abstract:

PURPOSE OF REVIEW:Substantial risk of ASCVD events persists despite intensive statin therapy and other agents to lower LDL-C. The optimal way to address other elements of dyslipidemia, such as triglyceride-rich particles (TRL) and when to treat has remained unclear. RECENT FINDINGS:Several lines of evidence indicate that TRL are associated with atherogenesis, partly because of associated factors, such as cholesterol-enriched remnant particles, high LDL particle number, high apo-B, high apo-CIII, and others. High triglyceride is increasingly prevalent because of worsening of lifestyle factors, obesity, and diabetes. Trials with fibrates, and niacin to reduce residual dyslipidemia have not provided evidence of benefits after statin therapy, thus far. A recent trial with an omega 3 fatty acid (OM3FA), icosapent-ethyl (IPE), provided evidence for a 25% reduction in ASCVD events in statin-treated high-risk population. These results were unexplained by triglyceride reduction alone, and are likely related to unique biologic effects of IPE on atherosclerosis. Finally, in patients with very high triglycerides, lifestyle measures and several triglyceride-lowering agents are indicated, often in combination, to prevent episodes of pancreatitis. A novel Apo C-III inhibitor may provide additional benefit in such patients. SUMMARY:There is evidence for the benefits of IPE in preventing ASCVD events. A novel fibrate is in clinical trials.

journal_name

Curr Opin Lipidol

authors

Ganda OP

doi

10.1097/MOL.0000000000000694

subject

Has Abstract

pub_date

2020-08-01 00:00:00

pages

238-245

issue

4

eissn

0957-9672

issn

1473-6535

journal_volume

31

pub_type

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