(Adnkronos) - “A seconda del livello di rischio è importante restare entro certi valori di colesterolo Ldl, comunemente chiamato ‘colesterolo cattivo’. Per i soggetti ad alto rischio bisogna cercare di stare alla larga da tutti i valori superiori a 70 mg/dl e, per i pazienti ad altissimo rischio, a 55 mg/dl”. Lo ha detto Alberico Catapano, presidente di Sisa, Società italiana per lo studio dell’aterosclerosi intervenendo alla campagna Novartis ‘Da Quore a Cuore’.
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00:00The link between cholesterol and LDL, which is commonly referred to as bad cholesterol and cardiovascular disease, is beyond any doubt.
00:14It is a causal link, because it is demonstrated by genetics, epidemiology, biology, research studies, but even more importantly by clinical trials,
00:25in which lowering cholesterol leads to a reduction of events.
00:30So there is no doubt today, but also in recent years, that LDL cholesterol is causal, and lowering it brings a benefit.
00:39The values you need to keep away from tend to depend on your cardiovascular risk.
00:45Today we are talking about subjects who have a very high or high risk, so the values you need to keep away from are all values above a value of 70 mg per person at high risk and 55 mg per person at very high risk.
01:00You have to tend to go below these levels, which are the therapeutic goals promulgated by the European guidelines of ESC and the European Society of Telosclerosis.
01:11So be careful, there is not a fixed number, but there is a number that depends on the level of risk.
01:17The risk factors, especially the causal ones, interact with each other.
01:22And this is already summarized when we talk about people at high or very high risk, because they are included in this analysis.
01:31When we talk about 55 mg per person at very high risk or less, we are talking about people who have either had an event, or have diabetes for a long time, or have hypertension.
01:42That is, it is already included in the risk assessment, so you don't have to go crazy.
01:47Just identify if the subject, who is one or more, has a high or very high risk, and then start an adequate therapy.
01:55In today's therapy we have two new things.
02:00The first is the underlining of the fact that therapeutic adherence is important, but we have known this for a long time.
02:07We have known this for a long time and it is a problem that, alas, remains unsolved.
02:11It remains unsolved because it is very complex, there is not a single factor.
02:15There are many factors that contribute, both on the part of the patient and on the part of the doctor and on the part of the health system,
02:21which may even involuntarily put obstacles to access some drugs.
02:26On the other hand, there is the issue of novelties.
02:30Fortunately, this is a very fertile field, with many novelties that pass from synthetic molecules.
02:37We also have new synthetic molecules today, for example, that inhibit PCSK9 orally,
02:43but especially small interfering RNAs, molecules that are targeted,
02:49they directly hit the hepatocytes and here inhibit the production of messenger RNA for the proteins of interest.
02:56A striking example is the inhibition of the production of PCSK9 and therefore the reduction of LDL cholesterol.