Peter Toth, MD: Facing Complications in Lipid Management

In the second part of an interview with HCPLIve, Peter Toth, MD, Director of Preventive Cardiology, CGH Medical Center, discussed the use of new agents for lipid management and whether they will become primary or secondary agents in the treatment.

"I think for the most part, virtually all of them can be used in combination with statins, or ezetimibe, or probably even the PCSK9 monoclonals," Toth said. "But let's say a patient is statin intolerant, then it gives you a whole new mechanistic approach by which to try and impact risk and lower atherogenic lipoprotein burden in serum."

He noted that clinicians can now take advantage of alternative pathways for reducing LDL-C and serum pathways that were once not possible.

Further, Toth spoke on the effects of the COVID-19 pandemic on cholesterol levels in patients who were currently being treated for various comorbid conditions.

He noted people stopped their medication and did not visit the hospital during a cardiovascular event for fear of becoming infected with COVID-19.

"We lost an average of one and a half years of life expectancy in the US due to the COVID pandemic," Toth said. "I'm absolutely certain that not only was the trend for rising cardiovascular mortality extended, but I'm sure it's spiked. We have a lot to learn, we're certainly going to have to think of novel ways to protect our patients from future pandemics."

Lastly, Toth observed the complications of statin adherence, as more patients believe themselves to be statin intolerant.

"In the last 10 years, there has been a continuous rise in cardiovascular mortality among both men and women," Toth said. "Despite the fact that for the previous 30 years, it was a clear downward trend. So we have these miracle drugs, they're being inadequately used, and often for false pretenses being stopped."

Watch the first part of the interview with Peter Toth, MD here.