Dual-lipid-lowering therapy (DULT) is more effective than statin monotherapy in high-risk patients with coronary artery disease (CAD), according to a recent review. The review determined that in recent trials, combination strategies involving a statin and non-statin agent have been shown to promote coronary atherosclerosis regression and improve cardiovascular (CV) outcomes in patients with moderate-to-high CV risk. The authors concluded:
- DULT should be implemented in patients above the recommended low-density lipoprotein cholesterol (LDL-C) target on a high-intensity statin and might be proposed as a first-line strategy in certain patients regardless of their LDL-C levels.
- Preference for 1 of the 2 strategies (NPC1L1 blockade or PCSK9 inhibition) should be evaluated case by case, according to the patient’s characteristics, LDL-C levels, risk profile, and national regulatory agency indications.
Gragnano F, Calabró P. Role of dual lipid-lowering therapy in coronary atherosclerosis regression: Evidence from recent studies. Atherosclerosis. 2018;269:219-228. doi:10.1016/j.atherosclerosis.2018.01.012.
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