Next Article in Journal
The Brain–Intestinal Mucosa–Appendix– Microbiome–Brain Loop
Next Article in Special Issue
Genomic Influence in the Prevention of Cardiovascular Diseases with a Sterol-Based Treatment
Previous Article in Journal
Elevated Gene Expression of Interleukin-32 Isoforms Alpha, Beta, Gamma, and Delta in the Peripheral Blood of Chronic Psoriatic Patients
Previous Article in Special Issue
Rosuvastatin Improves Vaspin Serum Levels in Obese Patients with Acute Coronary Syndrome
Open AccessReview

Lipid Target in Very High-Risk Cardiovascular Patients: Lesson from PCSK9 Monoclonal Antibodies

Department of Cardio-Thoracic and Respiratory Sciences, Section of Cardiology, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
*
Author to whom correspondence should be addressed.
Diseases 2018, 6(1), 22; https://doi.org/10.3390/diseases6010022
Received: 14 January 2018 / Revised: 12 March 2018 / Accepted: 14 March 2018 / Published: 17 March 2018
The role of low-density lipoproteins (LDLs) as a major risk factor for cardiovascular disease has been demonstrated by several epidemiological studies. The molecular basis for LDLs in atherosclerotic plaque formation and progression is not completely unraveled yet. Pharmacological modulation of plasma LDL-C concentrations and randomized clinical trials addressing the impact of lipid-lowering interventions on cardiovascular outcome have clearly shown that reducing plasma LDL-C concentrations results in a significant decrease in major cardiovascular events. For many years, statins have represented the most powerful pharmacological agents available to lower plasma LDL-C concentrations. In clinical trials, it has been shown that the greater the reduction in plasma LDL-C concentrations, the lower the rate of major cardiovascular events, especially in high-risk patients, because of multiple risk factors and recurrent events. However, in a substantial number of patients, the recommended LDL target is difficult to achieve because of different factors: genetic background (familial hypercholesterolemia), side effects (statin intolerance), or high baseline plasma LDL-C concentrations. In the last decade, our understanding of the molecular mechanisms involved in LDL metabolism has progressed significantly and the key role of proprotein convertase subtilisin/kexin type 9 (PCSK9) has emerged. This protein is an enzyme able to bind the LDL receptors (LDL-R) on hepatocytes, favoring their degradation. Blocking PCSK9 represents an intriguing new therapeutic approach to decrease plasma LDL-C concentrations, which in recent studies has been demonstrated to also result in a significant reduction in major cardiovascular events. View Full-Text
Keywords: lipoproteins; atherosclerosis; cardiovascular risk; statin; PCSK9 lipoproteins; atherosclerosis; cardiovascular risk; statin; PCSK9
Show Figures

Figure 1

MDPI and ACS Style

Ciccarelli, G.; D’Elia, S.; De Paulis, M.; Golino, P.; Cimmino, G. Lipid Target in Very High-Risk Cardiovascular Patients: Lesson from PCSK9 Monoclonal Antibodies. Diseases 2018, 6, 22.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop