What is the role of a lipid profile in the workup of noncoronary atherosclerosis?

Updated: Dec 23, 2019
  • Author: F Brian Boudi, MD, FACP; Chief Editor: Yasmine S Ali, MD, FACC, FACP, MSCI  more...
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Answer

Answer

Elevated LDL cholesterol is a risk factor for atherosclerotic vascular disease. High triglycerides associated with low high-density lipoprotein (HDL) cholesterol—a pattern categorized as atherogenic dyslipidemia and often found in insulin resistance—are also a risk factor for vascular disease. 

The dal-PLAQUE trial tested the safety and efficacy of dalcetrapib, using novel noninvasive multimodality imaging to assess structural and inflammatory indices of atherosclerosis as primary endpoints. The results suggest that dalcetrapib showed no evidence of a pathological effect related to the arterial wall over 24 months; however, dalcetrapib may have potential beneficial vascular effects, including the reduction in total vessel enlargement over 24 months. The long-term safety and efficacy needs to be further investigated. [7]

Nicholls et al studied the efficacy and safety of cholesteryl ester transfer protein (CETP) inhibitors in combination with commonly used statins. They found that, compared with placebo or statin monotherapy, evacetrapib raised HDL-C and lowered LDL-C levels, with or without a statin drug. [8]

In an industry-supported study, patients with atherosclerotic cardiovascular disease and LDL-C levels of < 70 mg/dl (1.81 mol/L) experienced no incremental clinical benefit from the addition of niacin to statin therapy during a 36-month follow-up period, despite significant improvements in HDL-C and triglyceride levels. [9]


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