Abstract
Cardiovascular diseases are still the most common cause of death worldwide, particularly in industrialized countries, including our country. In the Czech Republic, cardiovascular diseases accounts for almost half of all deaths (more than 50 % of women and men are slightly below 50 %).
The most important step in reducing cardiovascular morbidity and mortality is the prevention an influence of risk factors. It is a generally accepted direction in the prevention and treatment of cardiovascular diseases.
Pharmacological treatment of hyperlipidemia and dyslipidemia is considered one of the most effective preventive and therapeutic procedures. After the discovery of statins and their implementation in practice in 90 of those years, it seemed that the development of lipid lowering drugs is over.
Only one new molecule, ezetimibe, is missing data from a large intervention trial (which changed in the publication of the study IMPROVE IT) and new drugs have not progressed into clinical practice. Just in recent years is the possibility to influence plasma lipid and lipoprotein greatly expanding significantly.
The new drugs that are targeted primarily at homozygous familial hypercholesterolemia are lomitapid and mipomersen. The most significant progress and promise of lipid-lowering therapy is considered today a monoclonal antibody or PCSK9 inhibitors.
Such parenterally administered drugs reduce LDL-C by 50, 60 percent or more, moreover, decrease the concentration of apolipoprotein B and even lipoprotein(a). For this particular group, we do not have the latest data from controlled studies of mortality morbidity.
Nevertheless, preliminary, but significant data from meta-analyzes and safety monitoring suggest positive trends in reducing cardiovascular diseases.