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
. 2024 Jun 3;16(6):e61572.
doi: 10.7759/cureus.61572. eCollection 2024 Jun.

A Systematic Review and Meta-Analysis on the Role of Bempedoic Acid in Cardiovascular Outcomes for Patients With Statin Intolerance

Mohamed H Serour  1 , Musab Egaimi  2   1 , Zahid Khan  3   4   5   6
Affiliations
Review

A Systematic Review and Meta-Analysis on the Role of Bempedoic Acid in Cardiovascular Outcomes for Patients With Statin Intolerance

Mohamed H Serour et al. Cureus. .

Abstract

Atherosclerosis, a multifaceted pathogenic process affecting the arteries and aorta, poses a significant threat because of its potential to impede or entirely obstruct blood flow by narrowing blood vessels. This intricate progression involves various factors such as dyslipidemia, immunological responses, inflammation, and endothelial dysfunction. The initial phase manifests as the formation of fatty streaks, considered a pivotal hallmark in the inception of atherosclerotic plaques, a process that can commence as early as childhood. Over time, this process evolves, characterized by the thickening of the arterial inner layer (intima) and accumulation of lipid-laden macrophages, commonly known as foam cells, along with the buildup of the extracellular matrix. Subsequent stages witness the proliferation and aggregation of smooth muscle cells, culminating in the formation of atheroma plaques. As these lesions progress, apoptosis can occur in the deeper layers, further recruiting macrophages, which may undergo calcification and transform into atherosclerotic plaques. Notably, mechanisms such as arterial remodeling and intraplaque hemorrhage also contribute significantly to the progression of atherosclerotic cardiovascular disease, although these facets fall beyond the scope of this article. This study aimed to systematically review and conduct a meta-analysis of randomized controlled trials investigating the efficacy and safety of bempedoic acid in statin-intolerant patients with hyperlipidemia and to provide conclusions and recommendations accordingly. A systematic search of databases, such as PubMed, Web of Science, and Embase, will be performed. Only randomized trials will be included comparing bempedoic acid with placebo in statin-intolerant patients. This study aimed to provide a comprehensive understanding of the role of bempedoic acid in managing hyperlipidemia in statin-intolerant patients. In primary prevention, for patients unable to tolerate recommended statins, bempedoic acid was associated with a significant reduction in major adverse cardiovascular events (MACE) as the primary endpoint.

Keywords: " "atherosclerotic cardiovascular disease; adverse cardiovascular outcomes; bempedoic acid; cardiovascular disease prevention; cardiovascular disease risk factor; high-statin therapy; hyperuricemia. dyslipidemia. bmi .fbs . cardiovascular risk; pattern of dyslipidemia; statin intolerance; statin use.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart.
Figure 2
Figure 2. Risk-of-bias summary plot for studies included in the meta-analysis.
Figure 3
Figure 3. Risk-of-bias traffic light plot for studies included in the meta-analysis.
Figure 4
Figure 4. Forest plot of a three-point MACE.
MACE, major adverse cardiovascular event
Figure 5
Figure 5. Forest plot of a four-point MACE in patients with and without previous atherosclerotic cardiovascular disease.
MACE, major adverse cardiovascular event
Figure 6
Figure 6. shows the data for adverse event incidence in Bempedoic acid vs. control groups
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Olvera Lopez E, Ballard BD, Jan A. Treasure Island, FL: StatPearls ; 2024. Cardiovascular Disease. - PubMed
    1. Cardiovascular disease (CVD) and associated risk factors among older adults in six low-and middle-income countries: results from SAGE Wave 1. Ruan Y, Guo Y, Zheng Y, et al. BMC Public Health. 2018;18:778. - PMC - PubMed
    1. ESC/EAS Guidelines for the management of dyslipidaemias: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS) Reiner Z, Catapano AL, De Backer G, et al. Eur Heart J. 2011;32:1769–1818. - PubMed
    1. Mechanisms underlying direct actions of hyperlipidemia on myocardium: an updated review. Yao YS, Li TD, Zeng ZH. Lipids Health Dis. 2020;19:23. - PMC - PubMed
    1. A modern approach to dyslipidemia. Berberich AJ, Hegele RA. Endocr Rev. 2022;43:611–653. - PMC - PubMed

LinkOut - more resources