Acquired low cholesterol: diagnosis and relevance to safety of low LDL therapeutic targets

Soran, Handrean; Ho, Jan Hoong; Durrington, Paul N.

doi:10.1097/mol.0000000000000526

Cited by 7 publications

(2 citation statements)

References 81 publications

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“…Patients with tuberculosis, receiving statin treatment responded more rapidly to anti-tuberculous drugs and had lower rates of reactivation [ 50 ]. This effect is likely to be due to the decrease in circulating low-density lipoprotein cholesterol (LDL-C) rather than to a direct effect on the bacterium itself or the macrophage foam cellsm which are its host in the tuberculoma, because very little statin survives its first pass through the liver to reach the lungs [ 51 ].…”

Section: Recommendationsmentioning

confidence: 99%

“…Lipid metabolism changes in patients with acute illness and sepsis; high density lipoprotein cholesterol (HDL-C) tends to lose its anti-inflammatory effect and LDL-C tends to be more susceptible to atherosclerotic modifications [ 51 ]. Furthermore, atherosclerotic plaques may become more vulnerable to rupture predisposing to an acute cardiovascular event, so it is importance to continue with lipid modifying agents except in cases where risks outweigh benefits.…”

Section: Recommendationsmentioning

confidence: 99%

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Managing hyperlipidaemia in patients with COVID-19 and during its pandemic: An expert panel position statement from HEART UK

Iqbal

Adam

et al. 2020

Atherosclerosis

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Background & aims The emergence of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which causes Coronavirus Disease 2019 (COVID-19) has resulted in a worldwide pandemic. SARS-CoV-2 is highly contagious and its severity highly variable. The fatality rate is unpredictable but is amplified by several factors including advancing age, atherosclerotic cardiovascular disease, diabetes mellitus, hypertension and obesity. A large proportion of patients with these conditions are treated with lipid lowering medication and questions regarding the safety of continuing lipid-lowering medication in patients infected with COVID-19 have arisen. Some have suggested they may exacerbate their condition. It is important to consider known interactions with lipid-lowering agents and with specific therapies for COVID-19. This statement aims to collate current evidence surrounding the safety of lipid-lowering medications in patients, who have COVID-19. We offer a consensus view based on current knowledge and we rated the strength and level of evidence for these recommendations. Methods Pubmed, Google scholar and Web of Science were searched extensively for articles using search terms: SARS-CoV-2, COVID-19, coronavirus, Lipids, Statin, Fibrates, Ezetimibe, PCSK9 monoclonal antibodies, nicotinic acid, bile acid sequestrate, nutraceuticals, red yeast rice, Omega-3-Fatty acids, Lomitapide, hypercholesterolaemia, dyslipidaemia and Volanesorsen. Results & Conclusions : There is no evidence currently that lipid lowering therapy is unsafe in patients with COVID-19 infection. Lipid-lowering therapy should not be interrupted because of the pandemic or in patients at increased risk of COVID-19 infection. In patients with confirmed COVID-19, care should be taken to avoid drug interactions, between lipid-lowering medications and drugs that may be used to treat COVID-19, especially in patients with abnormalities in liver function tests.

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Section: Recommendationsmentioning

confidence: 99%

Section: Recommendationsmentioning

confidence: 99%

Managing hyperlipidaemia in patients with COVID-19 and during its pandemic: An expert panel position statement from HEART UK

Iqbal

Adam

et al. 2020

Atherosclerosis

Self Cite

View full text Add to dashboard Cite

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Management of Dyslipidemia in Patients with Non-Alcoholic Fatty Liver Disease

Martin

Lang

Goeser

et al. 2022

Curr Atheroscler Rep

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Purpose of Review Patients with non-alcoholic fatty liver disease (NAFLD), often considered as the hepatic manifestation of the metabolic syndrome, represent a population at high cardiovascular risk and frequently suffer from atherogenic dyslipidemia. This article reviews the pathogenic interrelationship between NAFLD and dyslipidemia, elucidates underlying pathophysiological mechanisms and focuses on management approaches for dyslipidemic patients with NAFLD. Recent Findings Atherogenic dyslipidemia in patients with NAFLD results from hepatic and peripheral insulin resistance along with associated alterations of hepatic glucose and lipoprotein metabolism, gut dysbiosis, and genetic factors. Summary Since atherogenic dyslipidemia and NAFLD share a bi-directional relationship and are both major driving forces of atherosclerotic cardiovascular disease (ASCVD) development, early detection and adequate treatment are warranted. Thus, integrative screening and management programs are urgently needed. A stepwise approach for dyslipidemic patients with NAFLD includes (i) characterization of dyslipidemia phenotype, (ii) individual risk stratification, (iii) definition of treatment targets, (iv) lifestyle modification, and (v) pharmacotherapy if indicated.

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Reply to: "Comments on 'Optimising treatment of hyperlipidaemia: Quantitative evaluation of UK, USA and European guidelines taking account of both LDL cholesterol levels and cardiovascular disease risk' "

2019

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Acquired low cholesterol: diagnosis and relevance to safety of low LDL therapeutic targets

Abstract: When hypocholesterolaemia is discovered, it is important to identify its cause. Further research into the pathogenesis of hypocholesterolaemia may provide new therapies for primary diseases underlying it.

Cited by 7 publications

References 81 publications

Managing hyperlipidaemia in patients with COVID-19 and during its pandemic: An expert panel position statement from HEART UK

Managing hyperlipidaemia in patients with COVID-19 and during its pandemic: An expert panel position statement from HEART UK

Management of Dyslipidemia in Patients with Non-Alcoholic Fatty Liver Disease

Reply to: "Comments on 'Optimising treatment of hyperlipidaemia: Quantitative evaluation of UK, USA and European guidelines taking account of both LDL cholesterol levels and cardiovascular disease risk' "

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