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Prof. Bryan PY YAN


Prof. Bryan PY YAN

Professor and Head, Division of Cardiology (Academic Affairs),
Department of Medicine & Therapeutics
Director (Clinical Sciences), Heart & Vascular Institute
Director, Master of Science in Cardiology Programme
Faculty of Medicine, The Chinese University of Hong Kong
Honorary Consultant, Prince of Wales Hospital, Hospital Authority


Current and emerging lipid management in the treatment of ACS

By Prof. Bryan Yan

LDL-C is one of the key risk factors associated with plaque formation and CV events. International guidelines retain a treatment goal approach to lipid management with an individualized target depending on patients’ baseline CV risk level – with the higher the CV risk, the lower the target LDL-C. However, there is still a major gap in the achievement of LDL-C goal which may be due to the use of less intensive statins, or the lack of lipid-lowering agents’ combinations.

With an aim to minimize the gap, current guidelines recommend the combination of statin, ezetimibe and PCSK9 inhibitor in patients at very-high-risk not achieving LDL-C goal for secondary prevention. The addition of PCSK9 inhibitor to oral treatments had been proven in large clinical trial to substantially reduce LDL-C and to reduce CV event risk.  Apart from cholesterol lowering effect, recent studies also demonstrated the use of PCSK9 inhibitor could lead to favorable coronary plaque changes like plaque regression and stabilization. There are also several emerging lipid-lowering therapies which could significantly reduce LDL-C and we are waiting for their CV outcome and long-term safety results.

This presentation provides a review of the (1) hypercholesterolemia guideline recommendations; (2) clinical evidence and the anti-atherosclerotic effect of lipid-lowering therapies.