Strategies to alter the trajectory of atherosclerotic cardiovascular disease

Packard, C. J. (2019) Strategies to alter the trajectory of atherosclerotic cardiovascular disease. Current Opinion in Lipidology, 30(6), pp. 438-445. (doi: 10.1097/MOL.0000000000000643) (PMID:31609725)

Abstract

Purpose of review: Cardiovascular disease prevention trials of lipid lowering with statins have shown unexpected long-term benefits after the formal randomized treatment stopped. This finding needs further exploration because it raises the possibility that the trajectory of the disease can be modified. Recent findings: Extended follow up data are now available from further major primary prevention studies and from meta-analyses of the legacy effect of statin trials. New outcome studies have been proposed and launched to test the ability of early intervention to slow or regress atherosclerosis. Summary: Legacy effects are apparent in trials of LDL lowering in hypercholesterolemic and hypertensive patient cohorts. Over follow up periods of decades, both cardiovascular mortality and all-cause mortality are reduced in individuals who received 3 to 5 years of statin therapy. The phenomenon is observed also in studies of intensive glycemic control suggesting that it is possible to impact plaque development with long-term beneficial consequences. Novel strategies for primary prevention are being devised that include the early use of both prolonged-moderate and short-term aggressive LDL lowering.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Packard, Professor Chris
• Authors: Packard, C. J.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: Current Opinion in Lipidology
• Publisher: Lippincott, Williams and Wilkins
• ISSN: 0957-9672
• ISSN (Online): 1473-6535
• Published Online: 11 October 2019
• Copyright Holders: Copyright © 2019 Wolters Kluwer Health, Inc.
• First Published: First published in Current Opinion in Lipidology 30(6):438-445:
• Publisher Policy: Reproduced in accordance with the publisher copyright policy