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Nicht nur ein erhöhtes LDL-Cholesterin, sondern auch ein niedriges HDL-Cholesterin und hohe Triglyzeride korrelieren im multifaktoriellen Prozess der Atherombildung eng mit dem Auftreten von kardiovaskulären Ereignissen. Verschiedene Studien haben eine hohe Prävalenz von Fettstoffwechselstörungen sowie des metabolischen Syndroms in Deutschland gezeigt. Als erster medikamentöser Therapieansatz zur Behandlung einer Fettstoffwechselstörung gilt nach wie vor die Verordnung von Statinen. Allerdings verbleibt trotz Therapie ein relevantes kardiovaskuläres Risiko. Daher ist es wichtig, zusätzlich eine adäquate Senkung der Triglyzeride sowie eine Erhöhung des HDL-Cholesterins zu erreichen. Mehrere Studien haben gezeigt, dass sowohl die Behandlung mit Statin und Nikotinsäure/Laropiprant als auch die Behandlung mit Statinen und Omega-3-Fettsäuren sowie für selektive Gruppen (Patienten mit hohen Triglyzeriden und niedrigem HDL-Cholesterin) die Einnahme von Statin und Fibrat sinnvolle Kombinationen für die multimodale Therapie von Fettstoffwechselstörungen darstellen. Für die Zukunft ist eine Umsetzung der Studienergebnisse in Deutschland mit Einbeziehung von Therapieempfehlungen bezüglich niedrigem HDL-Cholesterin und hohen Triglyzeriden in unsere Leitlinien notwendig.
Clinical Research in Cardiology Supplements – Springer Journals
Published: Apr 7, 2011
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