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Expert perspective: reducing cardiovascular risk in metabolic syndrome and type 2 diabetes mellitus beyond low-density lipoprotein cholesterol lowering.
Am J Cardiol 2008; 102(12A):41L-47LAJ

Abstract

Even with optimal statin therapy, many patients with type 2 diabetes mellitus or metabolic syndrome fail to achieve all lipid targets and remain at high risk of cardiovascular events. Add-on lipid-modifying therapy that is effective in improving the triglyceride and high-density lipoprotein (HDL) cholesterol abnormalities characteristic of these conditions is a recommended approach to reduce this risk. Fibrates or niacin is a logical option, supported by clinical studies showing improved lipid control in combination with a statin. Of the fibrates, fenofibrate may offer microvascular benefits in type 2 diabetes--as demonstrated by the Diabetes Atherosclerosis Intervention Study (DAIS) and the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study--as well as a low risk of myopathy when combined with statins compared with gemfibrozil. Although there is good evidence that both agents favorably affect clinical outcome, we need to evaluate their impact against a baseline of statin therapy. We await data from ongoing large-scale studies to evaluate the efficacy and safety of these combinations and to determine the most appropriate option for reducing residual cardiovascular risk in this important patient population.

Authors+Show Affiliations

Section of Atherosclerosis and Lipid Research, Baylor College of Medicine, Houston, Texas 77030, USA. jones@bmc.tmc.edu

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

19084089

Citation

Jones, Peter H.. "Expert Perspective: Reducing Cardiovascular Risk in Metabolic Syndrome and Type 2 Diabetes Mellitus Beyond Low-density Lipoprotein Cholesterol Lowering." The American Journal of Cardiology, vol. 102, no. 12A, 2008, pp. 41L-47L.
Jones PH. Expert perspective: reducing cardiovascular risk in metabolic syndrome and type 2 diabetes mellitus beyond low-density lipoprotein cholesterol lowering. Am J Cardiol. 2008;102(12A):41L-47L.
Jones, P. H. (2008). Expert perspective: reducing cardiovascular risk in metabolic syndrome and type 2 diabetes mellitus beyond low-density lipoprotein cholesterol lowering. The American Journal of Cardiology, 102(12A), pp. 41L-47L. doi:10.1016/j.amjcard.2008.09.074.
Jones PH. Expert Perspective: Reducing Cardiovascular Risk in Metabolic Syndrome and Type 2 Diabetes Mellitus Beyond Low-density Lipoprotein Cholesterol Lowering. Am J Cardiol. 2008 Dec 22;102(12A):41L-47L. PubMed PMID: 19084089.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Expert perspective: reducing cardiovascular risk in metabolic syndrome and type 2 diabetes mellitus beyond low-density lipoprotein cholesterol lowering. A1 - Jones,Peter H, PY - 2008/12/17/entrez PY - 2009/11/7/pubmed PY - 2009/12/16/medline SP - 41L EP - 47L JF - The American journal of cardiology JO - Am. J. Cardiol. VL - 102 IS - 12A N2 - Even with optimal statin therapy, many patients with type 2 diabetes mellitus or metabolic syndrome fail to achieve all lipid targets and remain at high risk of cardiovascular events. Add-on lipid-modifying therapy that is effective in improving the triglyceride and high-density lipoprotein (HDL) cholesterol abnormalities characteristic of these conditions is a recommended approach to reduce this risk. Fibrates or niacin is a logical option, supported by clinical studies showing improved lipid control in combination with a statin. Of the fibrates, fenofibrate may offer microvascular benefits in type 2 diabetes--as demonstrated by the Diabetes Atherosclerosis Intervention Study (DAIS) and the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study--as well as a low risk of myopathy when combined with statins compared with gemfibrozil. Although there is good evidence that both agents favorably affect clinical outcome, we need to evaluate their impact against a baseline of statin therapy. We await data from ongoing large-scale studies to evaluate the efficacy and safety of these combinations and to determine the most appropriate option for reducing residual cardiovascular risk in this important patient population. SN - 1879-1913 UR - https://www.unboundmedicine.com/medline/citation/19084089/Expert_perspective:_reducing_cardiovascular_risk_in_metabolic_syndrome_and_type_2_diabetes_mellitus_beyond_low_density_lipoprotein_cholesterol_lowering_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(08)01664-0 DB - PRIME DP - Unbound Medicine ER -