Moderne Strategien zur Lipidsenkung – die frühe Kombinationstherapie

Cardiovascular diseases are the most common cause of death worldwide. Apart from arterial hypertension and diabetes mellitus, dyslipidaemia is the most important and best modifiable cardiovascular risk factor.  LDL cholesterol reduction is based on lifestyle modification and statin therapy (atorvastatin, rosuvastatin). LDL lowering is most effective when statins are combined with ezetimibe. If LDL-C targets are not achieved with combined lipid lowering therapy, escalation with bempedoic acid and PCSK9 inhibitors (evolocumab, alirocumab, inclisiran) is recommended. After coronary artery bypass grafting (CABG), patients are considered to be at very high cardiovascular risk. For this patient population, a target LDL-C < 1.4 mmol/l, comparable to patients after acute myocardial infarction.