Bempedoic Acid and Statins in Lipid-Lowering Strategy: Which Came First, the Egg or the Chicken?
The goal in cardiovascular prevention is the reduction of morbidity and mortality through the promotion of healthy lifestyles in the general population. The management of modifiable risk factors with pharmacological and non-pharmacological interventions, based on the individual risk is the first str...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-04-01
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| Series: | Future Pharmacology |
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| Online Access: | https://www.mdpi.com/2673-9879/3/2/24 |
| _version_ | 1797594718762172416 |
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| author | Francesco Natale Riccardo Molinari Rosa Franzese Noemi Mollo Giovanni Cimmino |
| author_facet | Francesco Natale Riccardo Molinari Rosa Franzese Noemi Mollo Giovanni Cimmino |
| author_sort | Francesco Natale |
| collection | DOAJ |
| description | The goal in cardiovascular prevention is the reduction of morbidity and mortality through the promotion of healthy lifestyles in the general population. The management of modifiable risk factors with pharmacological and non-pharmacological interventions, based on the individual risk is the first strategy suggested by the current guidelines. Several epidemiological studies have clearly shown the direct correlation between high levels of low-density lipoprotein cholesterol (LDL-C) and incidence of cardiovascular diseases. On the other hand, numerous randomized clinical studies have reported a huge benefit in terms of major cardiovascular events achievable by the reduction of LDL-C, thus supporting the notion that “the lower is better”. Among the lipid-lowering strategies, statins are the drugs of choice in cardiovascular prevention, at both primary and secondary level. To achieve the ambitious targets suggested by the current guidelines, other lipid-lowering therapies are currently available in addition to statins, such as ezetimibe the inhibitors of the PCSK9. Pharmacological research has recently led to the development of a new drug, the bempedoic acid, which further enrich the available therapies. This drug also acts on the biosynthesis of cholesterol but at upstream level than statins. From the biochemical point of view, it has the potential to be considered before the statin with consequent titration of statins to achieve the desirable LDL-C target. In the present review, the biochemical and pharmacological characteristics of bempedoic acid are discussed. An overview of the clinical data that support its use in the management of the cardiovascular patient and its allocation in the lipid-lowering scenario will be also provided. |
| first_indexed | 2024-03-11T02:26:11Z |
| format | Article |
| id | doaj.art-30d8661564404273b7b57a1db9416466 |
| institution | Directory Open Access Journal |
| issn | 2673-9879 |
| language | English |
| last_indexed | 2024-03-11T02:26:11Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Future Pharmacology |
| spelling | doaj.art-30d8661564404273b7b57a1db94164662023-11-18T10:30:38ZengMDPI AGFuture Pharmacology2673-98792023-04-013239240610.3390/futurepharmacol3020024Bempedoic Acid and Statins in Lipid-Lowering Strategy: Which Came First, the Egg or the Chicken?Francesco Natale0Riccardo Molinari1Rosa Franzese2Noemi Mollo3Giovanni Cimmino4Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, ItalyVanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, ItalyVanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, ItalyVanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, ItalyDepartment of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, ItalyThe goal in cardiovascular prevention is the reduction of morbidity and mortality through the promotion of healthy lifestyles in the general population. The management of modifiable risk factors with pharmacological and non-pharmacological interventions, based on the individual risk is the first strategy suggested by the current guidelines. Several epidemiological studies have clearly shown the direct correlation between high levels of low-density lipoprotein cholesterol (LDL-C) and incidence of cardiovascular diseases. On the other hand, numerous randomized clinical studies have reported a huge benefit in terms of major cardiovascular events achievable by the reduction of LDL-C, thus supporting the notion that “the lower is better”. Among the lipid-lowering strategies, statins are the drugs of choice in cardiovascular prevention, at both primary and secondary level. To achieve the ambitious targets suggested by the current guidelines, other lipid-lowering therapies are currently available in addition to statins, such as ezetimibe the inhibitors of the PCSK9. Pharmacological research has recently led to the development of a new drug, the bempedoic acid, which further enrich the available therapies. This drug also acts on the biosynthesis of cholesterol but at upstream level than statins. From the biochemical point of view, it has the potential to be considered before the statin with consequent titration of statins to achieve the desirable LDL-C target. In the present review, the biochemical and pharmacological characteristics of bempedoic acid are discussed. An overview of the clinical data that support its use in the management of the cardiovascular patient and its allocation in the lipid-lowering scenario will be also provided.https://www.mdpi.com/2673-9879/3/2/24low-density lipoproteinsatherosclerosislipid-lowering strategy |
| spellingShingle | Francesco Natale Riccardo Molinari Rosa Franzese Noemi Mollo Giovanni Cimmino Bempedoic Acid and Statins in Lipid-Lowering Strategy: Which Came First, the Egg or the Chicken? Future Pharmacology low-density lipoproteins atherosclerosis lipid-lowering strategy |
| title | Bempedoic Acid and Statins in Lipid-Lowering Strategy: Which Came First, the Egg or the Chicken? |
| title_full | Bempedoic Acid and Statins in Lipid-Lowering Strategy: Which Came First, the Egg or the Chicken? |
| title_fullStr | Bempedoic Acid and Statins in Lipid-Lowering Strategy: Which Came First, the Egg or the Chicken? |
| title_full_unstemmed | Bempedoic Acid and Statins in Lipid-Lowering Strategy: Which Came First, the Egg or the Chicken? |
| title_short | Bempedoic Acid and Statins in Lipid-Lowering Strategy: Which Came First, the Egg or the Chicken? |
| title_sort | bempedoic acid and statins in lipid lowering strategy which came first the egg or the chicken |
| topic | low-density lipoproteins atherosclerosis lipid-lowering strategy |
| url | https://www.mdpi.com/2673-9879/3/2/24 |
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