Correction of hypertriglyceridemia as a basis for reducing residual cardiovascular risk: focus on fenofibrate

• Olga A. Polyakova
• Sergey V. Cheremushkin
• Olga D. Ostroumova

Abstract

Abstract. Cardiovascular disease (CVD) continues to be the leading cause of death worldwide. Reliable and extensive data from epidemiological, genetic, and clinical intervention studies have clearly demonstrated that low-density lipoprotein cholesterol (LDL–C) is a strong causative factor of atherosclerosis and an important determinant of cardiovascular risk. However, despite an intensive approach to lowering LDL–С, there is a significant residual risk of CVD even at extremely low LDL–С levels.

Hypertriglyceridemia (HTG) and elevated levels of triglyceride-rich lipoproteins (TRLs) are among the main causal residual risk factors of atherosclerotic CVD. Adequate correction of elevated LDL–С levels is the cornerstone of pharmacotherapy in patients with HTG. However, statins, ezetimibe and new monoclonal antibodies against proprotein convertase subtilisin-kexin type 9 are highly effective in reducing LDL–C levels, but they have no significant effect on triglyceride (TG) and TRLs levels. Currently, an effective class of drugs recognized by modern Russian and European guidelines for blood high-TG levels reducing are fibrates.

In this regard, this article presents a brief overview of the relationship between TG, TRLs and atherosclerosis and discusses the current results in TG-lowering therapy, especially the use of fenofibrate.

Keywords:triglycerides; hypertriglyceridemia; non-HDL cholesterol; residual risk; fenofibrate

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