[Residual risk of cardiovascular complications and its reduction with a combination of lipid lowering agents]

Abstract

Most patients treated with statins die due to cardiovascular events. The risk of cardiovascular event during statin treatment is called residual risk. The source of residual risk are some risk factors including dyslipidemia, characterized by low HDL-cholesterol, elevated triglycerides and apolipoprotein B, small dense LDL and sometimes also high lipoprotein(a). High residual risk is common in patients with metabolic syndrome, type 2 diabetes mellitus, insulinoresistance and abdominal obesity. Residual risk can be decreased by combination therapy statins with fibrates or statins with niacin; niacin can affect almost all lipids and lipoproteins that participate in residual risk. There are evidences from clinical trials that combinations statin with fibrates or statin with niacin are safe.