Special Episode- Residual Risk - A Focus on Triglycerides – November 2024
Nov 11, 2024
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Christie Ballantyne, a renowned cardiologist and director at Baylor College of Medicine, joins Dr. Neil Skolnik to delve into the often-overlooked role of triglycerides in cardiovascular risk. They discuss the limitations of standard treatments like statins and highlight the need for innovative strategies to manage residual risk. The conversation covers the impact of omega-3 fatty acids, the importance of lifestyle changes in diabetic patients, and the benefits of smart technology in monitoring heart health. This informative dialogue emphasizes a holistic approach to cardiovascular disease management.
Residual risk remains a significant concern for cardiovascular events despite statin treatment, necessitating comprehensive evaluation of individual risk factors.
The use of icosapent ethyl as an adjunct therapy has shown promise in reducing cardiovascular risk in patients with high triglyceride levels.
Deep dives
Understanding Residual Risk in Cardiovascular Disease
Residual risk refers to the persistent risk of cardiovascular events that remains even after patients have been treated with statins, which primarily lower LDL cholesterol. Despite significant advancements in lipid management through statins, studies indicate that a considerable percentage of patients continue to experience cardiovascular incidents, highlighting the importance of recognizing this ongoing risk. Therefore, healthcare providers need to comprehensively address cardiovascular risk factors, including lifestyle modifications and additional therapeutic options, in order to optimize patient outcomes. This underscores the necessity of evaluating each patient's unique risk profile to identify those who may require further intervention beyond standard statin therapy.
The Role of Triglycerides as a Risk Marker
Triglycerides serve as a critical risk marker for cardiovascular disease, especially for patients who remain at high risk despite achieving optimal LDL levels with statin therapy. High triglyceride levels can indicate a significant residual risk, as some individuals continue to face cardiovascular events even after lifestyle changes and standard treatments are implemented. The discussion emphasized the complexity surrounding the relationship between triglyceride levels and cardiovascular outcomes, including the mixed results from various clinical trials involving other lipid-altering medications. This highlights the lack of consensus regarding effective treatment strategies for triglyceride reduction and the need for tailored approaches for patients exhibiting high triglyceride levels.
Emerging Evidence on Omega-3 Fatty Acids
Emerging evidence supports the use of icosapent ethyl, a type of omega-3 fatty acid, as an effective adjunct therapy for patients with elevated triglycerides who are already on statins. Clinical trials have demonstrated that icosapent ethyl significantly reduces the risk of cardiovascular events, contrasting with mixed findings from other lipid-modulating treatments such as niacin and fibrates. The differentiation of omega-3 fatty acids, particularly their potential anti-inflammatory properties and effects on cardiovascular outcomes, was emphasized throughout the discussion. As a result, guidelines now suggest considering the addition of icosapent ethyl for individuals with controlled LDL levels but persistently high triglycerides to help mitigate residual cardiovascular risk.
In this special episode on Residual Risk: A Focus on Triglycerides, our host, Dr. Neil Skolnik will discuss Residual Risk, Triglycerides and how to reduce residual risk with Dr. Christie Ballantyne, Director of the Center for Cardiometabolic Disease Prevention, Baylor College of Medicine. Based on popular demand this episode, originally aired in August 2023, is being republished for our audience.
This special episode is supported by an independent educational grant from Amarin.
Presented by:
Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health
Dr. Christie Ballantyne. Dr. Ballantyne is a Professor of Medicine-Cardiology, and Director of the Center for Cardiometabolic Disease Prevention, Baylor College of Medicine.