ASCVD Management: Making the Case for Nonstatin Therapies
Feb 21, 2023
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Join Drs. Neha Pagidipati, Christie Ballantyne, and Gregory Piazza in a lively discussion on ASCVD management, including nonstatin therapies, challenges in patient care, and alternative treatment options. Explore the evolution towards combination therapy, considerations for statin-intolerant patients, and the importance of personalized treatment plans. Delve into the efficacy and tolerability of PCSK9 inhibitors and azetamide for statin-hesitant patients, and the benefits of combining medications to lower LDL cholesterol effectively in high-risk patients.
Assessing individual responses crucial for achieving LDL targets with statins alone.
Nonstatin therapies like PCSK9 inhibitors or ezetimibe are essential for patients unresponsive to statin monotherapy.
Deep dives
Challenges in Achieving LDL Goals with Statin Therapy Alone
High-risk patients with atherosclerotic cardiovascular disease often struggle to reach LDL cholesterol targets with statins alone. Various factors, such as statin intolerance or insufficient dosage, hinder goal achievement. The discussion highlights the importance of assessing individual patient responses, exploring different statins or dosages, and considering non-statin therapies when statin monotherapy falls short.
Treatment Options Beyond Statins for High-Risk Patients
For patients unable to reach LDL targets with statins, alternative therapies are essential. Options include PCSK9 inhibitors, like monoclonal antibodies or inclisiran, as well as ezetimibe or bempedoic acid. Combining medications, assessing side effects, and tailoring treatments to patient profiles play a crucial role in optimizing LDL control and reducing cardiovascular risk.
Utilizing Novel Therapies and Considerations for Patient Optimization
The evolving landscape of lipid-lowering therapies offers personalized approaches for patients. Inclisiran's biannual dosage provides a convenient regimen, while challenges such as insurance coverage may affect therapy access. Acknowledging patient factors like high calcium scores or extensive atherosclerosis guides clinicians in selecting suitable treatments and striving for improved cardiovascular outcomes.
In this episode of Cholesterol Conversations, join Drs. Neha Pagidipati, Christie Ballantyne, and Gregory Piazza for a roundtable discussion that addresses recent guidance on ASCVD management, current gaps in ASCVD care, patient barriers to LDL-C lowering, and nonstatin therapies to consider for patients who don’t respond to statin therapy alone.
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