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    Dyslipidemia

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    Deepthi Avvaru
    Dyslipidemias are disorders of lipoprotein metabolism that can be manifested by elevated total cholesterol, LDL, and triglycerides or decreased HDL cholesterol. Various lipoproteins transport lipids between the intestine, liver, and peripheral tissues. Indians have a high prevalence of dyslipidemias characterized by high triglycerides, low HDL, and small dense LDL, increasing cardiovascular risk. Screening involves a lipid profile and calculating risk scores. Treatment involves statins and other drugs to modify lipid levels according to risk categories. New advances like PCSK9 inhibitors have provided additional treatment options for severe hypercholesterolemia.

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    Dyslipidemia

    Uploaded by

    Deepthi Avvaru
    42 views18 pages
    Dyslipidemias are disorders of lipoprotein metabolism that can be manifested by elevated total cholesterol, LDL, and triglycerides or decreased HDL cholesterol. Various lipoproteins transport lipids between the intestine, liver, and peripheral tissues. Indians have a high prevalence of dyslipidemias characterized by high triglycerides, low HDL, and small dense LDL, increasing cardiovascular risk. Screening involves a lipid profile and calculating risk scores. Treatment involves statins and other drugs to modify lipid levels according to risk categories. New advances like PCSK9 inhibitors have provided additional treatment options for severe hypercholesterolemia.

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    Dyslipidemias are disorders of lipoprotein metabolism that can be manifested by elevated total cholesterol, LDL, and triglycerides or decreased HDL cholesterol. Various lipoproteins transport lipids between the intestine, liver, and peripheral tissues. Indians have a high prevalence of dyslipidemias characterized by high triglycerides, low HDL, and small dense LDL, increasing cardiovascular risk. Screening involves a lipid profile and calculating risk scores. Treatment involves statins and other drugs to modify lipid levels according to risk categories. New advances like PCSK9 inhibitors have provided additional treatment options for severe hypercholesterolemia.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    42 views18 pages

    Dyslipidemia

    Uploaded by

    Deepthi Avvaru
    Dyslipidemias are disorders of lipoprotein metabolism that can be manifested by elevated total cholesterol, LDL, and triglycerides or decreased HDL cholesterol. Various lipoproteins transport lipids between the intestine, liver, and peripheral tissues. Indians have a high prevalence of dyslipidemias characterized by high triglycerides, low HDL, and small dense LDL, increasing cardiovascular risk. Screening involves a lipid profile and calculating risk scores. Treatment involves statins and other drugs to modify lipid levels according to risk categories. New advances like PCSK9 inhibitors have provided additional treatment options for severe hypercholesterolemia.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 18

    DYSLIPIDEMIA

    Dr Avvaru Deepthi
    KLE college of pharmacy
    Dyslipidemia

    Dyslipidemias are disorders of lipoprotein metabolism, including lipoprotein


    overproduction or deficiency. These disorders may be manifested by elevation of the
    serum total cholesterol, LDL and triglyceride concentrations and a decrease in HDL
    cholesterol concentration.

    Various lipoproteins:
    • Transport dietary lipids from intestine
    to liver (exogenous)
    • Transport lipids from liver to
    peripheral tissues (endogenous)
    • Cholesterol is a waxy substance
    produced and released by cells in the
    liver.
    • The body uses cholesterol to form cell
    membranes, aid in digestion, convert
    Vitamin D in the skin and
    develop hormones.
    • Lipoproteins form a package for the
    cholesterol:
    • Low density lipoproteins (LDL)
    • High density lipoproteins (HDL)
    Fredrickson classification of dyslipidemia
    PATHOPHYSIOLOGY
    Screening

    • Lipid profile
    • HDL
    • Triglyceride
    • Calculated LDL-C
    • Fredrickson classification , particle size, c- reactive
    protein
    • Ankle brachial index less than 0.9
    • Apo lipoprotein B more than 130mg/dl
    • Framingham risk score
    Lipid association of India

    • Indian expert consensus document on management of


    dyslipidemia in Indians.
    • Compared with the western populations, Indians tend to have
    higher triglyceride levels and lower HDL-C but the total
    cholestrol and LDL-C levels are generally lower.
    • Indians have high prevalence of diabetes, obesity and metabolic
    syndrome, all of which are characterised by high TG levels, low
    HDL-C and higher prevalence of small dense LDL particles,
    which is also known as atherogenic dyslipidemia.
    • Among various lipid markers, the ratio of apolipoprotein B to
    apolipoprotein A-1 appears to be the best indicator of ASCVD
    risk.
    Risk category
    Treatment goals and statin initation thresholds
    according to ASCVD risk categories

    Pharmacological treatment
    •HMG –CoA reductase inhibitors : atorvastatin , rosuvastatin
    •Bile acid sequestrants : cholestryamine, colesevelam
    •Fibrates : fenofibrate, gemfibrozil
    •Nicotinic acid : niacin
    •Cholestrol absorption inhibitors : ezetimibe
    •PCSK-9 inhibitors : alirocumab
    International guidelines: AHA
    International guidelines: AHA
    COVID-19

    • There is scarcity of evidence regarding the efficacy and risk


    of different strategies in patients with COVID-19 disease.
    • COVID-19 disease may trigger destabilisation of chronic
    CVD.
    • Aspirin dosage given for the secondary prevention of
    atherothrombosis has no anti-inflammatory potential and
    there should not be interrupted in COVID-19 patients
    without any other relevant reasons.
    • Anti- viral therapy, it is of major importance to correct
    modifiable predisposing factors.
    SARS-COV-2 infection causes
    dyslipidemia
    Advances in the management of
    dyslipidemia

    • PCSK9-I
    • PCSK9 inhibition by Monoclonal antibodies
    • Evolocumab or Alirocumab are second line treatments for hyperlipidaemia.
    • Human monoclonal antibodies; PCSK9 inhibitors can be given (140 mg injection every 2 weeks )
    • when LDL is persistently above the thresholds despite maximal tolerated lipid-lowering therapy.
    • Binding of LDL with PCSK9 leads to degradation of the LDL receptor, and then less LDL is removed
    from the circulation.
    • Inhibiting PCSK9 from being degraded therefore promotes removal of LDL cholesterol from
    circulation
    • After subcutaneous administration of alirocumab, maximal suppression of free PCSK9 occurs within 4
    to 8 hours.

    • Inclisiran
    • Ethyl ester of eicosapentaenoic acid
    • THANK YOU

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