Abstract
Dyslipidemia treatment for the prevention of coronary artery disease (CAD) is mainly based on statin administration, although low-density lipoprotein (LDL)-lowering therapy using statins alone has some limitations. The efficacy of ezetimibe and protein convertase subtilisin kexin (PCSK) 9 inhibitors as combination drugs with statins has been established, with PCSK9 inhibitors having a particularly strong LDL-lowering effect. LDL-lowering therapy has been widely accepted; however, from a medical-economic perspective, PCSK9 inhibitors cannot be used in all patients. Hypertriglyceridemia is the next target of dyslipidemia treatment. Hypertriglyceridemia causes cardiovascular events by increasing low-density LDL cholesterol levels in the blood. It has been reported that the “LDL window”, which is defined by high non-HDL (≥ 170 mg/dL) and high TG (≥ 150 mg/dL) levels, correlates significantly with the serum small dense LDL levels. In this study, we report that stratification using the LDL window in patients undergoing secondary prevention of CAD is a significant predictor of cardiovascular events. Treatment of hypertriglyceridemia with awareness of stratification based on the LDL window may therefore be effective in preventing adverse events in high-risk patients with dyslipidemia.
