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Dr D. Ramesh discusses lipoprotein & heart disease

Various therapeutic strategies to manage cholesterol levels

Published: Mar 20, 2023 10:16:28 AM IST

Dr D. Ramesh discusses lipoprotein & heart diseaseStudies like the Framingham Study, MRFIT, and Seven Countries Study all demonstrate a connection between elevated blood cholesterol levels and cardiovascular events. LDL-C, in particular, has been linked to these events. Moreover, factors like smoking, high blood pressure, diabetes, obesity, and modified lipid metabolism can increase the risk of atherosclerosis. As a result, lowering LDL-C levels may help reduce the chance of myocardial infarction and other cardiovascular issues.

The LDL-C lowering strategies include the administration of therapeutics that inhibit cholesterol synthesis, such as:

  • Statins: inhibits LDL & Cholesterol Production.
  • Bempedoic acid: interferes with the cholesterol biosynthesis pathway.
  • Ezetimibe: suppresses cholesterol absorption
  • Bile acid sequestrants: help lower LDL cholesterol
  • PCSK9 inhibitors: is a serine protease that regulates LDL-C homeostasis.
  • Evolocumab and alirocumab: monoclonal antibodies against PCSK9
  • The most advanced non-antibody approach is inclisiran, a small interfering RNA directed against PCSK9.
  • Lomitapide and Mipomersen: interfere with the synthesis of ApoB-containing lipoprotein particles.
To control lipoprotein(a), lowering strategies involve the administration of PCSK9 inhibitors, niacin, and CETP inhibitors or Lipoprotein apheresis.

The triglyceride levels can be controlled with the help of fibrates, niacin, and n-3 fatty acids.

LPL gene therapy -Alipogene tiparvovec is an adeno-associated virus serotype 1-based gene therapy used to control the lipid levels in the body.

Clinical research and studies have consistently emphasized that following a healthy lifestyle and keeping a check on potent risk factors can help reduce the risk of CVD, avert CVD-associated complications and prevent mortality.

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