Bempedoic Acid’s Use as an Adjunct in Lowering Low-Density Lipoprotein Cholesterol in Patients With Coronary Artery Disease: A Systematic Review

Goit, Raman; Saddik, Samia E; Dawood, Sarah N; Rabih, Ahmad M; Niaj, Ahmad; Raman, Aishwarya; Uprety, Manish; Calero, Maria Jose; Villanueva, Maria Resah B; Joshaghani, Narges; Villa, Nicole; Badla, Omar; Khan, Safeera

doi:10.7759/cureus.29891

Cited by 3 publications

(1 citation statement)

References 25 publications

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“…The influence of lipids on the development of arteriosclerotic disease is known [78], which produces an inflammation of the arterial wall with accumulation of lipids in it [79].…”

Section: Discussionmentioning

confidence: 99%

Relationship between Atherogenic Dyslipidaemia and Lipid Triad and Scales That Assess Insulin Resistance

et al. 2023

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Background: Atherogenic dyslipidaemia (AD) and lipid triad (LT) are characterised by high triglyceride levels together with low HDL and normal or high LDL cholesterol and are favoured by a persistent state of insulin resistance (IR), which increases the release of free fatty acids from abdominal adipose tissue. This alteration in the lipid profile favours the accelerated development of atherosclerosis, which is the most important cause of morbidity and mortality in all countries in the developed and developing world. One of the elements that plays a major role in the genesis of AD is IR. The aim of this study was to determine the relationship between variables that assess atherogenic risk (AD and LT) and scales that assess the risk of presenting insulin resistance. Methods: A descriptive cross-sectional study of 418,343 workers was conducted to evaluate atherogenic dyslipidaemia and lipid triad; a relationship with three insulin resistance risk scales (Triglycerides/HDL, TyG index, METS-IR) was established. The usefulness of IR risk scales for predicting AD and LT was calculated by applying ROC curves, obtaining the area under the curve (AUC) and cut-off points with their sensitivity, specificity, and Youden index. Multivariate analysis was performed by binary logistic regression. Results: The prevalence of high-risk values for insulin resistance with all of the scales is much higher in people with AD and LT compared to those without. The ROC curves present us with an AUC with the three insulin resistance risk scales for the two dyslipidaemias studied with figures ranging between 0.856 and 0.991, which implies that the results are good/very good. Conclusions: A relationship between atherogenic dyslipidaemia and the three insulin resistance risk scales assessed is revealed, with higher IR mean values and prevalence in people with atherogenic dyslipidaemia and lipid triad. The three scales make it possible to adequately classify the presence of AD and LT. The highest AUC is presented by the triglycerides/HDL scale, with a result close to 1. METS-IR is the most recommended formula to estimate insulin resistance.

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“…The influence of lipids on the development of arteriosclerotic disease is known [78], which produces an inflammation of the arterial wall with accumulation of lipids in it [79].…”

Section: Discussionmentioning

confidence: 99%

Relationship between Atherogenic Dyslipidaemia and Lipid Triad and Scales That Assess Insulin Resistance

et al. 2023

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Assessment of the global and national market for lipid modifying agents: retrospective and innovation

Lokhmacheva,

Fominykh,

Trubina

et al. 2023

Sibirskij nauchnyj medicinskij zhurnal

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Lipid-lowering therapy is one of the most important aspects in the treatment of patients with cardiovascular disease, which is still the leading cause of death in the adult population. Over the past 10 years, fundamentally new lipid-lowering drugs have appeared such as alipogene tiparvovec, mipomersen, lomitapide, evolocumab, alirocumab, bempedoic acid, inclisiran, evinacumab, volanesorsen. In order to update information on the effectiveness and safety of the use of lipidlowering drugs, their consumption in the pharmaceutical market in retrospect and at the present time, a systematic search was carried out in the scientific databases eLIBRARY.RU, PubMed, Embase, ClinicalTrials.gov, the Cochrane Library, Russian State Register of Medicines from 1980 to 2023. Statins remain the main drugs of choice for regular use in violation of lipid metabolism. Fibrates are the drugs of choice in patients with rare forms of hyperlipidemia associated with high triglyceride level. A group of other lipid-lowering drugs has been characterized from the point of view of the mechanisms of action, indications for use, and the availability of registration certificates in the Russian Federation and in the world. The growing interest in ezetimibe in the Russian pharmaceutical market is confirmed by the high growth in the share of local companies in its production as part of the import substitution strategy. It has been established that the drug causes undesirable effects with a small degree of probability as part of combination therapy. Inhibitors of proprotein convertase subtilisin-kexin type 9 (PCSK9) open up new possibilities for the treatment of patients at very high risk of cardiovascular disease. Lomitapide is not registered in the Russian Federation, but since December 2021 it has been included in the list of medicines purchased by the Krug Dobra Foundation to help children with homozygous familial hypercholesterolemia. Since 2022, inclisiran, a drug inhibiting synthesis of PCSK9 with RNA interference, has been approved for use in Russia and is safe in patients with hyperlipidemia and statin intolerance. Thus, in the 21st century, fundamentally new positions have appeared in the group of lipid-lowering drugs, which are examples of biotechnological and gene therapy drugs.

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Case report: Strong low-density-cholesterol reduction accompanied by shrinkage of low-attenuation coronary plaque during lipid-lowering treatment with bempedoic acid—serial evaluation by coronary computed tomography angiography

Korosoglou

Giesen

Geiss

et al. 2023

Front. Cardiovasc. Med.

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Here, we present a patient with coronary artery disease and prior percutaneous coronary interventions. This patient had to discontinue taking multiple statins and ezetimibe due to intolerance with musculoskeletal complaints and nausea. Monotherapy with bempedoic acid was well tolerated and was exceptionally effective at lipid lowering, enabling patients to achieve the low-density lipoprotein target of <55 mg/dl, as recommended by current guidelines. In addition, serial coronary computed tomography angiography performed upon clinical indications, during 20 months of lipid-lowering treatment with bempedoic acid, demonstrated signs of favorable plaque component modification, with shrinkage of the low-attenuation plaque component compared to baseline findings.

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Bempedoic Acid’s Use as an Adjunct in Lowering Low-Density Lipoprotein Cholesterol in Patients With Coronary Artery Disease: A Systematic Review

Cited by 3 publications

References 25 publications

Relationship between Atherogenic Dyslipidaemia and Lipid Triad and Scales That Assess Insulin Resistance

Relationship between Atherogenic Dyslipidaemia and Lipid Triad and Scales That Assess Insulin Resistance

Assessment of the global and national market for lipid modifying agents: retrospective and innovation

Case report: Strong low-density-cholesterol reduction accompanied by shrinkage of low-attenuation coronary plaque during lipid-lowering treatment with bempedoic acid—serial evaluation by coronary computed tomography angiography

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