Expert opinion on targeted lipid control for very-high-risk Indian patients: bridging the gap in real-world practice
Author(s)
Type
Journal Article
Abstract
Despite robust clinical guidelines and the availability of potent lipid-lowering therapies (LLTs), many very-high-risk dyslipidaemia patients fail to achieve target LDL cholesterol (LDL-C) levels, primarily due to poor adherence and delayed treatment intensification. Two virtual meetings were convened involving a panel of senior cardiologists. Insights were synthesised into an expert framework, developed through polling and collective inputs from expert. The panel strongly recommends LDL-C target of <55 mg/dl (<1.4 mmol/l) for very-high-risk patients. A 2 × 2 matrix was proposed to tailor LLTs based on patient adherence and CV risk, emphasising early initiation of combination therapy and use of inclisiran in non-adherent patients. Patients with very high baseline LDL-C require combination therapy with high-intensity statins, with add-on proprotein convertase subtilisin/kexin type 9 inhibitors, which significantly enhances LDL-C reduction and improves goal attainment. A simplified decisionmaking algorithm that accounts for adherence and promotes timely treatment intensification with combination LLTs needs to be implemented to effectively lower LDL-C in very-high-risk Indian patients in clinical practice.
Date Issued
2025-12-15
Date Acceptance
2025-08-01
Citation
European Cardiology Review, 2025, 20
ISSN
1758-3756
Publisher
Radcliffe Medical Media Ltd
Start Page
e37
Journal / Book Title
European Cardiology Review
Volume
20
Copyright Statement
© The Author(s). This work is open access and is licensed under CC-BY-NC 4.0. Users may copy, redistribute and make derivative works for non-commercial purposes, provided the original work is cited correctly.
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/41523266
Subjects
Cardiovascular disease
LDL cholesterol
PCSK9 inhibitor
dyslipidaemia
lipid-lowering therapy
treatment adherence
Publication Status
Published
Coverage Spatial
England
Article Number
e37
Date Publish Online
2025-12-15