Keywords
Atherosclerotic cardiovascular disease
Bempedoic acid
Inclisiran
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Abstract
Objective: To Analyze the impact of LDL-C on atherosclerotic cardiovascular disease (ASCVD) and the effectiveness of non-statin lipid-lowering therapies, such as bempedoic acid and inclisiran, in controlling LDL-C and reducing cardiovascular risk. Literature review: LDL-C is a causal risk factor for ASCVD, the leading cause of global mortality. Although statins are the first-line therapy, significant residual risk justifies the use of additional therapies. Bempedoic acid inhibits ATP-citrate lyase in the liver, reducing LDL-C and hsCRP with a low incidence of myalgia, making it useful for patients intolerant to statins. Inclisiran, an RNA interference agent, silences PCSK9 in hepatocytes, providing a sustained reduction of LDL-C with semiannual administration, being effective in reducing LDL-C, total cholesterol, and apolipoprotein B. Conclusions: LDL-C is a central risk factor in ASCVD, and statin therapy remains first-line treatment. However, the adoption of non-statin lipid-lowering therapies, such as bempedoic acid and inclisiran, offers valuable options for patients with high cardiovascular risk who do not reach lipid targets with statins, contributing to LDL-C reduction and cardiovascular risk reduction, with strong evidence of safety and efficacy.
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