TY - JOUR
TI - Benefits and drawbacks of statins and non-statin lipid lowering agents in carotid artery disease
AU - Paraskevas, K.I.
AU - Gloviczki, P.
AU - Antignani, P.L.
AU - Comerota, A.J.
AU - Dardik, A.
AU - Davies, A.H.
AU - Eckstein, H.-H.
AU - Faggioli, G.
AU - Fernandes e Fernandes, J.
AU - Fraedrich, G.
AU - Geroulakos, G.
AU - Golledge, J.
AU - Gupta, A.
AU - Gurevich, V.S.
AU - Jawien, A.
AU - Jezovnik, M.K.
AU - Kakkos, S.K.
AU - Knoflach, M.
AU - Lanza, G.
AU - Liapis, C.D.
AU - Loftus, I.M.
AU - Mansilha, A.
AU - Nicolaides, A.N.
AU - Pini, R.
AU - Poredos, P.
AU - Proczka, R.M.
AU - Ricco, J.-B.
AU - Rundek, T.
AU - Saba, L.
AU - Schlachetzki, F.
AU - Silvestrini, M.
AU - Spinelli, F.
AU - Stilo, F.
AU - Suri, J.S.
AU - Svetlikov, A.V.
AU - Zeebregts, C.J.
AU - Chaturvedi, S.
AU - Veith, F.J.
AU - Mikhailidis, D.P.
JO - Progress in Cardiovascular Diseases
PY - 2022
VL - null
TODO - null
SP - null
PB - W.B. Saunders
SN - 0033-0620, 1532-8643
TODO - 10.1016/j.pcad.2022.05.003
TODO - null
TODO - International guidelines strongly recommend statins alone or in combination with other lipid-lowering agents to lower low-density lipoprotein cholesterol (LDL-C) levels for patients with asymptomatic/symptomatic carotid stenosis (AsxCS/SCS). Lowering LDL-C levels is associated with significant reductions in transient ischemic attack, stroke, cardiovascular (CV) event and death rates. The aim of this multi-disciplinary overview is to summarize the benefits and risks associated with lowering LDL-C with statins or non-statin medications for Asx/SCS patients. The cerebrovascular and CV beneficial effects associated with statins, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors and other non-statin lipid-lowering agents (e.g. fibrates, ezetimibe) are reviewed. The use of statins and PCSK9 inhibitors is associated with several beneficial effects for Asx/SCS patients, including carotid plaque stabilization and reduction of stroke rates. Ezetimibe and fibrates are associated with smaller reductions in stroke rates. The side-effects resulting from statin and PCSK9 inhibitor use are also highlighted. The benefits associated with lowering LDL-C with statins or non-statin lipid lowering agents (e.g. PCSK9 inhibitors) outweigh the risks and potential side-effects. Irrespective of their LDL-C levels, all Asx/SCS patients should receive high-dose statin treatment±ezetimibe or PCSK9 inhibitors for reduction not only of LDL-C levels, but also of stroke, cardiovascular mortality and coronary event rates. © 2022 Elsevier Inc.
ER -