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Review
. 2022 Aug 18;23(16):9326.
doi: 10.3390/ijms23169326.

Statins in High Cardiovascular Risk Patients: Do Comorbidities and Characteristics Matter?

Enrica Rossini  1 , Federico Biscetti  2 , Maria Margherita Rando  2 , Elisabetta Nardella  2 , Andrea Leonardo Cecchini  1 , Maria Anna Nicolazzi  2 , Marcello Covino  1   3 , Antonio Gasbarrini  1   4 , Massimo Massetti  1   5 , Andrea Flex  1   2
Affiliations
Review

Statins in High Cardiovascular Risk Patients: Do Comorbidities and Characteristics Matter?

Enrica Rossini et al. Int J Mol Sci. .

Abstract

Atherosclerotic cardiovascular disease (ASCVD) morbidity and mortality are decreasing in high-income countries, but ASCVD remains the leading cause of morbidity and mortality in high-income countries. Over the past few decades, major risk factors for ASCVD, including LDL cholesterol (LDL-C), have been identified. Statins are the drug of choice for patients at increased risk of ASCVD and remain one of the most commonly used and effective drugs for reducing LDL cholesterol and the risk of mortality and coronary artery disease in high-risk groups. Unfortunately, doctors tend to under-prescribe or under-dose these drugs, mostly out of fear of side effects. The latest guidelines emphasize that treatment intensity should increase with increasing cardiovascular risk and that the decision to initiate intervention remains a matter of individual consideration and shared decision-making. The purpose of this review was to analyze the indications for initiation or continuation of statin therapy in different categories of patient with high cardiovascular risk, considering their complexity and comorbidities in order to personalize treatment.

Keywords: LDL-cholesterol; atherosclerosis; cardiovascular disease; statin.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
How to decide which statin and what dosage.
Figure 2
Figure 2
Hydrophilic and lipophilic statins.
Figure 3
Figure 3
Intensity of statin therapy [12].
See this image and copyright information in PMC

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