Cardiovascular diseases. Introduction

Abstract

Cardiovascular diseases (CVDs) account for ∼30% of mortality, worldwide. Of the nine common risk factors for CVDs, the multinational INTERHEART study showed that dyslipidaemia, defined as an elevated apolipoprotein (apo) B:apoA1 ratio, is one of the most significant. The effective management of dyslipidaemia is therefore essential for the reduction of CV risk. It is well established that lowering low-density lipoprotein-cholesterol (LDL-C) levels using statins significantly reduces the level of CV risk in people with dyslipidaemia. A meta-analysis of 14 clinical trials, for example, demonstrated that each mmol/L reduction in LDL-C was associated with a 12% reduction in all-cause mortality, a 19% reduction in coronary mortality, and a 21% reduction in the total risk of major vascular events. Based on the results from this and similar studies, international treatment guidelines recommend lowering LDL-C to <2.0-2.6 mmol/L (<77-100 mg/dL) in patients with established CVDs and to <1.8-2.0 mmol/L (<70-77 mg/dL), where possible. Among the seven commonly used statins, pitavastatin is frequently used in Japan, South Korea, Thailand and China; it has recently been licensed for use in the USA and is now in the final stages of national approval within Europe. The following reviews discuss the safety and efficacy of pitavastatin for the treatment of dyslipidaemia relative to atorvastatin, simvastatin, and pravastatin, and examine its additional benefits beyond LDL-C reduction and its potential role in clinical practice.