Atherosclerotic cardiovascular disease (ASCVD) is the most common cause of death in the United States.1 Most deaths from ASCVD occur in patients with preexisting ASCVD. Secondary prevention trials in patients with established ASCVD demonstrate that low-density lipoprotein cholesterol (LDL-C)–lowering therapy with statins reduces recurrent cardiovascular events. Recently, new nonstatin drugs, notably ezetimibe and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, have been introduced as statin add-on drugs for LDL-C lowering. This article reviews evidence-based strategies for reducing LDL-C in secondary prevention.
Grundy SM, Stone NJ. 2018 American Heart Association/American College of Cardiology/Multisociety Guideline on the Management of Blood Cholesterol–Secondary Prevention. JAMA Cardiol. Published online April 17, 20194(6):589–591. doi:10.1001/jamacardio.2019.0911
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