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Am J Cardiol. 2008 Dec 22;102(12A):19L-27L. doi: 10.1016/j.amjcard.2008.09.071.

A review of the current status of the management of mixed dyslipidemia associated with diabetes mellitus and metabolic syndrome.

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  • 1Pritzker School of Medicine, University of Chicago, Chicago, Illinois 60610, USA.


Current treatment guidelines recommend lowering elevated low-density lipoprotein (LDL) cholesterol levels with a statin as the primary lipid-modifying intervention to reduce cardiovascular risk in patients with type 2 diabetes mellitus or metabolic syndrome. However, even with high-dose statin therapy or the combination of statin plus ezetimibe, many patients remain at substantial risk of a cardiovascular event. Increasingly, there is recognition of the importance of treating all components of the atherogenic dyslipidemic profile associated with both conditions, specifically low high-density lipoprotein cholesterol and elevated triglyceride levels, in addition to lowering LDL cholesterol. Both niacin (nicotinic acid) and fibrates are recommended as options for combination with a statin in this setting. Data from ongoing prospective outcomes studies are needed to evaluate the efficacy and safety of these combinations.

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