Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Apr 23:2018:8598054.
doi: 10.1155/2018/8598054. eCollection 2018.

Safety and Efficacy of Extremely Low LDL-Cholesterol Levels and Its Prospects in Hyperlipidemia Management

Dhrubajyoti Bandyopadhyay  1 , Arshna Qureshi  2 , Sudeshna Ghosh  3 , Kumar Ashish  4 , Lyndsey R Heise  5 , Adrija Hajra  6 , Raktim K Ghosh  7
Affiliations
Review

Safety and Efficacy of Extremely Low LDL-Cholesterol Levels and Its Prospects in Hyperlipidemia Management

Dhrubajyoti Bandyopadhyay et al. J Lipids. .

Abstract

The risk of cardiovascular disease has been reported to have a linear relationship with LDL levels. Additionally, the currently recommended LDL target goal of 70 mg/dl does not diminish the CV risk entirely leaving behind some residual risk. Previous attempts to maximally lower the LDL levels with statin monotherapy have met dejection due to the increased side effects associated with the treatment. Nevertheless, with the new advancements in clinical medicine, it has now become possible to bring down the LDL levels to as low as 15 mg/dl using PCSK9 monoclonal antibodies alone or in combination with statins. The development of inclisiran, siRNA silencer targeting PCSK9 gene, is a one step forward in these endeavors. Moreover, various studies aiming to lower the CV risk and mortality by lowering LDL levels have demonstrated encouraging results. The current challenge is to explore this arena to redefine the target LDL levels, if required, to avoid any suboptimal treatment. After thorough literature search in the PubMed, Embase, Scopus, and Google Scholar, we present this article to provide a brief overview of the safety and efficacy of lowering LDL below the current goal.

PubMed Disclaimer

Figures

Figure 1
Figure 1
LDL metabolism.
Figure 2
Figure 2
Mechanism of atherosclerosis.
See this image and copyright information in PMC

References

    1. Mozaffarian D., Benjamin E. J., Go A. S., et al. Circulation. Vol. 132. American Heart Association; 2015. Heart disease and stroke statistics—2016 update. - PubMed
    1. Mozaffarian D., Benjamin E. J., Go A. S., et al. Circulation. Vol. 131. American Heart Association; 2014. Heart Disease and Stroke Statistics—2015 Update. - PubMed
    1. Stone N. J., Robinson J., Lichtenstein A. H. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2013 doi: 10.1161/01.cir.0000437738.63853.7a. - DOI - PubMed
    1. Nayor M., Vasan R. S. Recent update to the us cholesterol treatment guidelines: A comparison with international guidelines. Circulation. 2016;133(18):1795–1806. doi: 10.1161/CIRCULATIONAHA.116.021407. - DOI - PMC - PubMed
    1. Boden W. E., Probstfield J. L., Anderson T., et al. Niacin in patients with low HDL cholesterol levels receiving intensive statin therapy. The New England Journal of Medicine. 2011;365(24):2255–2267. doi: 10.1056/nejmoa1107579. - DOI - PubMed

LinkOut - more resources