For a patient with known CAD and low baseline HDL, would a PCSK9 inhibitor be a better option than a statin, given concerns for paradoxical lowering of HDL levels with statin therapy that we can encounter in the outpatient clinical setting?

Answer from: at Academic Institution

Statin therapy would still be your first choice as we know that they reduce CVD related outcomes regardless of the HDL. In fact, studies show that patients with low HDL benefit even more from statin therapy.

Comments

at Cardiovascular Institute At Beth Israel Deaconess Medical Center
I agree.

Answer from: at Academic Institution

I agree with sticking to a statin. In fact, statins usually result in a modest increase in HDL.

Answer from: at Community Practice

Long-term studies support statin therapy first. Add PCSK9 if needed to further lower LDL.

Answer from: at Community Practice

Agree with statin as first line.

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For a patient with known CAD and low baseline HDL, would a PCSK9 inhibitor be a better option than a statin, given concerns for paradoxical lowering of HDL levels with statin therapy that we can encounter in the outpatient clinical setting?

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