@article{FruchartDavignonHermansetal.2014, author = {Fruchart, Jean-Charles and Davignon, Jean and Hermans, Michael P. and Al-Rubeaan, Khalid and Amarenco, Pierre and Assmann, Gerd and Barter, Philip and Betteridge, John and Bruckert, Eric and Cuevas, Ada and Farnier, Michel and Ferrannini, Ele and Fioretto, Paola and Genest, Jacques and Ginsberg, Henry N. and Gotto Jr., Antonio M. and Hu, Dayi and Kadowaki, Takashi and Kodama, Tatsuhiko and Krempf, Michel and Matsuzawa, Yuji and N{\´u}{\~n}ez-Cort{\´e}s, Jes{\´u}s Mill{\´a}n and Monfil, Calos Calvo and Ogawa, Hisao and Plutzky, Jorge and Rader, Daniel J. and Sadikot, Shaukat and Santos, Raul D. and Shlyakhto, Evgeny and Sritara, Piyamitr and Sy, Rody and Tall, Alan and Tan, Chee Eng and Tokg{\"o}zoğlu, Lale and Toth, Peter P. and Valensi, Paul and Wanner, Christoph and Zambon, Albertro and Zhu, Junren and Zimmet, Paul}, title = {Residual macrovascular risk in 2013: what have we learned?}, series = {Cardiovascual Diabetology}, volume = {13}, journal = {Cardiovascual Diabetology}, number = {26}, issn = {1475-2840}, doi = {10.1186/1475-2840-13-26}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-117546}, year = {2014}, abstract = {Cardiovascular disease poses a major challenge for the 21st century, exacerbated by the pandemics of obesity, metabolic syndrome and type 2 diabetes. While best standards of care, including high-dose statins, can ameliorate the risk of vascular complications, patients remain at high risk of cardiovascular events. The Residual Risk Reduction Initiative (R(3)i) has previously highlighted atherogenic dyslipidaemia, defined as the imbalance between proatherogenic triglyceride-rich apolipoprotein B-containing-lipoproteins and antiatherogenic apolipoprotein A-I-lipoproteins (as in high-density lipoprotein, HDL), as an important modifiable contributor to lipid-related residual cardiovascular risk, especially in insulin-resistant conditions. As part of its mission to improve awareness and clinical management of atherogenic dyslipidaemia, the R(3)i has identified three key priorities for action: i) to improve recognition of atherogenic dyslipidaemia in patients at high cardiometabolic risk with or without diabetes; ii) to improve implementation and adherence to guideline-based therapies; and iii) to improve therapeutic strategies for managing atherogenic dyslipidaemia. The R(3)i believes that monitoring of non-HDL cholesterol provides a simple, practical tool for treatment decisions regarding the management of lipid-related residual cardiovascular risk. Addition of a fibrate, niacin (North and South America), omega-3 fatty acids or ezetimibe are all options for combination with a statin to further reduce non-HDL cholesterol, although lacking in hard evidence for cardiovascular outcome benefits. Several emerging treatments may offer promise. These include the next generation peroxisome proliferator-activated receptor alpha agonists, cholesteryl ester transfer protein inhibitors and monoclonal antibody therapy targeting proprotein convertase subtilisin/kexin type 9. However, long-term outcomes and safety data are clearly needed. In conclusion, the R(3)i believes that ongoing trials with these novel treatments may help to define the optimal management of atherogenic dyslipidaemia to reduce the clinical and socioeconomic burden of residual cardiovascular risk.}, language = {en} }