A VOYAGER Meta-Analysis of the Impact of Statin Therapy on Low-Density Lipoprotein Cholesterol and Triglyceride Levels in Patients With Hypertriglyceridemia

Remnant cholesterol and risk of ischemic stroke in 112,512 individuals from the general population

“…In a recent study, including both individuals with clinically defined familial hypercholesterolemia, and individuals from the general population using common genetic variants associated with higher LDL cholesterol, we found no association between high LDL cholesterol and risk of ischemic stroke, except for in individuals with past ischemic heart disease . It could therefore be that remnant cholesterol lowering contributes to reducing the risk of ischemic stroke in statin trials, given that statins also reduce triglycerides and remnant cholesterol …”

“…Randomized clinical trials with statins have shown beneficial effects on lowering the risk of stroke, with the general belief being that this is mediated solely by lowering of LDL cholesterol; however, given that statins also reduce triglycerides and remnant cholesterol, it is possible that the stroke‐reducing effect of statins could be attributed to lowering of both LDL cholesterol and remnant cholesterol.…”

Effects of free omega-3 carboxylic acids and fenofibrate on liver fat content in patients with hypertriglyceridemia and non-alcoholic fatty liver disease: A double-blind, randomized, placebo-controlled study

“…Statins reduce LDL-C levels effectively, but there remains a residual CV risk associated with atherogenic dyslipidemia (low serum levels of HDL cholesterol [HDL-C] and high serum levels of TGs). 1,2 Mild to moderate hypertriglyceridemia, defined as serum TG levels of 2.0-10 mM (175-885 mg/dL), is associated with an increased risk of CV disease, as indicated by the results of recent Mendelian randomization studies. 3,4 In addition, severe hypertriglyceridemia, defined as serum TG levels of more than 10 mM (885 mg/dL), is associated with increased acute pancreatitis risk.…”

Strategies for the use of nonstatin therapies

“…A causal association between elevated TG, TGrich lipoproteins or their remnants and increased CVD risk has also been established, independent of LDL-C or HDL-C levels [3,[12][13][14][15][16][17]. Statins may affect TG and HDL-C levels: a dose-dependent TG reduction has been reported, ranging from 9 up to 25%, with greater reductions observed in patients with higher baseline TG values [18,19]; in addition, all statins are able to increase HDL-C and apoA-I independently of LDL-C reduction but related to the baseline TG levels [20,21].…”