Vnitr Lek 2024, 70(2):76-82 | DOI: 10.36290/vnl.2024.017

Treatment of dyslipidemia in metabolic syndrome

Michal Vrablík
3. interní klinika VFN a 1. LF UK Praha

Metabolic syndrome continues to represent one of the most common clinical situations associated with increased cardiometabolic risk in the Czech Republic. Dyslipidemia found in patients with metabolic syndrome is the main carrier of increased risk of atherothrombotic complications. Non-pharmacological measures improve all other components of the metabolic syndrome in addition to dyslipidemia. Their enforcement is difficult and pharmacotherapy should not be postponed, especially in persons at high and very high cardiovascular risk. Hypolipidemic treatment in people with metabolic syndrome should be based on a statin, possibly in combination with ezetimibe. For those intolerant to statins, we can now use bempedoic acid. Fenofibrate can be used in specific patients, it is necessary to test its effect on the concentrations of non-HDL-C and apolipoprotein B in a specific patient. The use of omega-3 fatty acids in our conditions is not relevant, the only demonstrably effective preparation (ethyl ester of eicosapentaenoic acid) is not available in the Czech Republic. PCSK9 therapies will help achieve target values even in difficult-to-treat patients in the high or very high risk categories.

Keywords: metabolic syndrome, dyslipidemia, statins, ezetimibe, bempedoic acid, PCSK9, fenofibrate.

Accepted: March 26, 2024; Published: April 10, 2024  Show citation

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Vrablík M. Treatment of dyslipidemia in metabolic syndrome. Vnitr Lek. 2024;70(2):76-82. doi: 10.36290/vnl.2024.017.
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