Details

Autor(en) / Beteiligte

• Wright, R. Scott
• Murphy, Joseph G.

Titel

Mitigating Risk Patients With Dyslipidemia: A Statin a Day Does Not Always Keep the Doctor Away in Those With Elevated Triglycerides

Ist Teil von

• Mayo Clinic proceedings, 2019-09, Vol.94 (9), p.1659-1661

Ort / Verlag

England: Elsevier Inc

Erscheinungsjahr

2019

Quelle

MEDLINE

Beschreibungen/Notizen

• Elevated TGs promote the formation of smaller, more dense LDL: a very atherogenic ApoB- containing lipoprotein.8,9 Recent speculation by Toth8 and Rosenson9 suggests that TG-rich lipoproteins likely alter atherosclerotic plaque in ways that favor plaque destabilization and progression of disease (Figure).9 The recent REDUCE-IT trial (Cardiovascular Event Risk reduction with icosapent ethyl trial) evaluated whether treatment with fish oil in addition to statin therapy might reduce cardiovascular risk. A second source of TGs is as part of the very low-density lipoprotein particles (VLDL) that transports TG generated from hepatic metabolism and are likely much more atherogenic.9-12 An elegant study by Ference et al reported in Journal of the American Medical Association, and an accompanying editorial by Navar, highlight the current speculation about the role of TGs and the impact of REDUCE-IT on reductions in cardiovascular risk.11,12 Ference et al evaluated genetic mutations in lipoprotein lipase (LPL), a key enzyme in metabolism of TG. Importantly, after adjusting for differences in ApoB levels, TGs were not independently related to cardiovascular risk. [...]differences in ApoB, not TG levels, may directly account for the observed lower risk of cardiovascular disease.