Targeting cardiovascular risk associated with both low density and high density lipoproteins using statin- XXXX combination therapy.

@entity1 @entity1670 @entity11429 @entity165
BACKGROUND: Cardiovascular risk might be reduced by targeted changes in both low density and high density lipoprotein @entity165 ( @entity11429 and HDL-C). This dual strategy will require a well tolerated, effective regimen, as well as a better understanding of how HDL-C may be targeted. DESIGN: An open-label, uncontrolled, retrospective cohort study of combined statin- @entity1670 therapy. METHODS: We reviewed all @entity1 ( n= 132) started on this combination in a referral lipid clinic over a 6.5-year period for tolerability, safety and effectiveness. RESULTS: Combined therapy was tolerated by 77% of @entity1 . No serious adverse events attributable to medication were encountered. In drug-naive @entity1 (n = 37), moderate doses of statin and @entity1670 (mean 1180 mg/day) reduced @entity11429 31% and increased HDL-C 29% ( P< 0.002, both comparisons). At @entity1670 doses >or= 1000 mg/day (mean 1480) added to a constant statin regimen (n=29), HDL-C increased 20% ( P< 0.001). Even at @entity1670 doses < 1000 mg/day (mean 580, n= 23), HDL-C increased 13% ( P< 0.05). Although mean HDL-C increased, the initial and final HDL-C distributions were broad and largely overlapping. Any chosen cutpoint for HDL-C goal would apply to only a minority of @entity1 . The total/HDL @entity165 ratio had narrower distributions, as the percentage of @entity1 with ratio < 5.0 increased from 17% to 67%. CONCLUSION: Combined statin- @entity1670 therapy lowers @entity11429 and raises HDL-C with acceptable tolerance and safety. If treating @entity11429 is the primary goal, consistent with current guidelines, then a strategy of targeting the total/HDL @entity165 ratio as a secondary goal is applicable to more @entity1 than targeting HDL-C itself.
