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Home / Podcast / Non-Statin Treatment for LDL Cholesterol with Dr. John J.P. Kastelein

Non-Statin Treatment for LDL Cholesterol with Dr. John J.P. Kastelein

February 23, 2023 by Alain Bouchard, MD 2 Comments

Dr. Bouchard discusses “Non-Statin Treatment for LDL Cholesterol ” with Dr. John J.P. Kastelein, M.D., Ph.D., FESC. Professor of Medicine, University of Amsterdam.

Despite the 30 years of advances in lipid management and more patients being treated with a statin, approximately 70% of our patients still remain at risk of developing an ASCVD event: In the FOURIER analysis of patients with cardiovascular disease treated with a statin only or with a statin and a PCSK9 antibody (evolocumab), patients on statin only had 20% more cardiovascular events that included: MI, stroke or death. The ODYSSEY clinical trial demonstrated the benefits of another PCSK9 inhibitor, Alirocumab on a background of statin treatment in patients who experienced an MI or unstable angina episode and lowered the incidence of adverse events by 15%.  IMPROVE-IT clinical trial demonstrated that the addition of ezetimibe to simvastatin was superior in preventing adverse cardiac outcomes compared to simvastatin alone with an absolute reduction of cardiac events by 2%.

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Comments

  1. Barbara Jann Moore says

    March 6, 2023 at 9:23 am

    I think I would be a very good candidate for one of these trials. Just on statin for 6 months. Bad side effects. Recent blood tests shows lower cholesterol- HDL-71.7 mg/dl – LDL, 84 mg/dl. But Lipoprotein A is 260.8 nmol/L.
    I am also hypertensive.

    Reply
    • Alain Bouchard, MD says

      April 7, 2023 at 11:47 am

      An elevated Lipoprotein A can increase the risk of heart disease. There are several centers participating in the Olpasiran, phase 3 clinical trial. You can consult clinicalTrials.gov to find a study site near you.

      Reply

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Alain Bouchard, MD

Dr. Alain Bouchard is a clinical cardiologist at Cardiology Specialists of Birmingham, AL. He is a native of Quebec, Canada and trained in Internal Medicine at McGill University in Montreal. He continued as a Research Fellow at the Montreal Heart Institute. He did a clinical cardiology fellowship at the University of California in San Francisco. He joined the faculty at the University of Alabama Birmingham from 1986 to 1990. He worked at CardiologyPC and Baptist Medical Center at Princeton from 1990-2019. He is now part of the Cardiology Specialists of Birmingham at St. Vincent's Health System, Ascension.

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