Negative impact of reducing lipid-lowering therapy after achieving target LDL-C in patients with a very high cardiovascular risk undergoing cardiac rehabilitation
- Student Scientific Club “Cardiacus’’ at the Department of Cardiology and Internal Medicine, Military Institute of Medicine – National Research Institute (WIM-PIB), Warsaw, Poland
- Department of Cardiology and Internal Diseases, Military Institute of Medicine – National Research Institute (WIM-PIB), Warsaw, Poland
Data publikacji online: 2026/04/23
Article file
- Ott
C, Schmieder RE. The role of statins in the treatment
of the metabolic syndrome. Curr Hypertens Rep. 2009; 11(2):
143-149.
Dayar
E, Pechanova O. Targeted strategy in lipid-lowering therapy.
Biomedicines. 2022; 10(5): 1090.
Lewis
SJ. Lipid-lowering therapy: who can benefit? Vasc Health Risk Manag.
2011; 7: 525-534.
Feher
MD. Lipid lowering to delay the progression of coronary
artery disease. Heart. 2003; 89(4): 451-458.
McDonagh
TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Buler
J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS,
Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes
AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR,
McMurray JJV, Mebazaa A, Mindham R, Muneretto C,
Piepoli MF, Price S, Rosano GMC, Ruschitzka F, Skibelund
AK; ESC Scientific Document Group. 2021 ESC Guidelines for
the diagnosis and treatment of acute and chronic heart
failure: Developed by the Task Force for the diagnosis and
treatment of acute and chronic heart failure of the European
Society of Cardiology (ESC) With the special contribution
of the Heart Failure Association (HFA) of the ESC.
European Heart J. 2021; 42(36): 3599-3726.
Byrne
RA, Rossello X, Coughlan JJ, Barbato E, Berry C, Chieffo A, Claeys
MJ, Dan GA, Dweck MR, Galbraith M, Gilard M, Hinterbuchner L,
Jankowska EA, Jüni P, Kimura T, Kunadian V, Leosdottir M, Lorusso R,
Pedretti RFE, Rigopoulos AG, Rubini Gimenez M, Thiele H, Vranckx P,
Wassmann S, Kass Wenger N, Ibanez B, ESC Scientific Document Group.
2023 ESC Guidelines for the management of acute coronary
syndromes: Developed by the task force on the management
of acute coronary syndromes of the European Society
of Cardiology (ESC). European Heart J. 2023; 44(38): 3720-3826.
Vrints
C, Andreotti F, Koskinas KC, Rossello X, Adamo M, Ainslie J, Banning
AP, Budaj A, Buechel RR, Chiariello GA, Chieffo A,
Christodorescu RM, Deaton C, Doenst T, Jones HW, Kunadian
V, Mehilli J, Milojevic M, Piek JJ, Pugliese F,
Rubboli A, Semb AG, Senior R, Ten Berg JM, Van Belle E, Van
Craenenbroeck EM, Vidal-Perez R, Winther S, ESC Scientific
Document Group. 2024 ESC Guidelines for the management
of chronic coronary syndromes: Developed by the task force
for the management of chronic coronary syndromes
of the European Society of Cardiology (ESC) Endorsed
by the European Association for Cardio-Thoracic Surgery (EACTS).
European Heart J. 2024; 45(36): 3415-3537.
Kardas
P, Kwiatek A, Włodarczyk P, Urbański F, Ciabiada- Bryła B. Is
the KOS-Zawał coordinated care program effective in reducing
long-term cardiovascular risk in coronary artery disease patients in
Poland? Insights from analysis of statin persistence in
a nationwide cohort. Pol Heart J. 2024; 82(9): 852-860.
Kardas
P, Kwiatek A, Włodarczyk P, Urbański F, Ciabiada- Bryła B. Statins
use amidst the pandemic: prescribing, dispensing, adherence,
persistence, and correlation with COVID-19 statistics in nationwide
real-world data from Poland. Front Pharmacol. 2024; 15: 1350717.
Cecha
P, Chromik A, Piotrowska I, Zabojszcz M, Dolecka- Ślusarczyk M,
Siudak Z. Assessment of application of the new 2019
European Society of Cardiology/European Atherosclerosis Society
Guidelines for the Management of Dyslipidaemias in daily
clinical practice – one center study. Folia Med Cracov. 2021;
61(3): 43-54.
Wełnicki
M, Śliż D, Filipiak K, Siebert J, Naruszewicz M, Mamcarz A. Różnice
w skuteczności leczenia dyslipidemii u mężczyzn
z rozpoznaną otyłością w porównaniu z mężczyznami
nieotyłymi. Badanie 3ST-POL. Forum Med Rodz. 2016; 10(4): 179-188.
Benn
M, Nordestgaard BG, Frikke-Schmidt R, Tybjærg-Hansen A. Low LDL
cholesterol, PCSK9 and HMGCR genetic variation, and risk
of Alzheimer’s disease and Parkinson’s disease: Mendelian
randomisation study. BMJ. 2017; 357: j1648.
Tada
H, Usui S, Sakata K, Takamura M, Kawashiri MA. Low-density
lipoprotein cholesterol level cannot be too low: considerations from
clinical trials, human genetics, and biology. J Atheroscler Thromb.
2020; 27(6): 489-498.
Knuuti
J, Wijns W, Saraste A, Capodanno D, Barbato E, Funck‑Brentano
C. Wytyczne ESC dotyczące rozpoznawania i leczenia przewlekłych
zespołów wieńcowych (2019). Polish Heart J. 2020; 78(I): 10-87.
Gao
Y, Ding J, Kim C, Spaulding E, Isakadze N, Stewart K, Broderick A,
Bush A, MacFarlane Z, Nimbalkar M, Desai A, Mathews L, Marvel F,
Garcvia-Garcia H, Mard- tin SS. Abstract 4142395: Lipid trends
of adults who participate in hybrid cardiac rehabilitation.
Circulation. 2024; 150 (suppl 1).
Meslet
JB, Dugué B, Brisset U, Pianeta A, Kubas S. Evaluation of a hybrid
cardiovascular rehabilitation program in acute coronary syndrome
low-risk patients organised in both cardiac rehabilitation and sport
centres: a model feasibility study. Int J Environ Res Public
Health. 2022; 19(15): 9455.
Harzand
A, Alrohaibani A, Idris MY, Spence H, Parrish CG, Rout PK, Nazar R,
Davis-Watts ML, Wright PP, Vakili AA, Abdelhamid S, Vathsangam
H, Adesanya A, Park LG, Whooley MA, Wenger NK, Zafari AM, Shah
AJ. Effects of a patient-centered digital health
intervention in patients referred to cardiac rehabilitation:
the Smart HEART clinical trial. BMC Cardiovasc Disord. 2023;
23(1): 453.
Scolaro
B, Nogueira MS, Paiva A, Bertolami A, Barroso LP, Vaisar T, Heffron
SP, Fisher EA, Castro IA. Statin dose reduction with complementary
diet therapy: a pilot study of personalized medicine. Mol
Metab. 2018; 11: 137-144.
Schoeneck
M, Iggman D. The effects of foods on LDL cholesterol
levels: a systematic review of the accumulated
evidence from systematic reviews and meta-analyses of randomized
controlled trials. Nutr Metab Cardiovasc Dis. 2021; 31(5): 1325-1338.
Lira
FS, Zanchi NE, Lima-Silva AE, Pires FO, Bertuzzi RC, Santos RV,
Caperuto É, Kiss M, Seelaender M. Acute high-intensity exercise with
low energy expenditure reduced LDL-c and total cholesterol in men.
Eur J Appl Physiol. 2009; 107(2): 203-210.
Fang
HSA, Gao Q, Lee ML, Hsu W, Tan NC. LDL-cholesterol change and goal
attainment following statin intensity titration among Asians in
primary care: a retrospective cohort study. Lipids Health Dis.
2021; 20(1): 2.
Goldstein
LB, Toth PP, Dearborn-Tomazos JL, Giugliano RP, Hirsh BJ, Peña JM,
Selim MH, Woo D; American Heart Association Council on
Arteriosclerosis, Thrombosis and Vascular Biology; Council on
Cardiovascular and Stroke Nursing; Council on Peripheral Vascular
Disease; and Stroke Council. Aggressive LDL-C lowering and the brain:
impact on risk for dementia and hemorrhagic stroke: a scientific
statement from the American Heart Association. Arterioscler
Thromb Vasc Biol. 2023; 43(10): e404-e442.
Starzyk
K, Wożakowska-Kapłon B. Objawy mięśniowe w przebiegu
stosowania statyn – fakty, mity, rzeczywistość i stanowiska
ekspertów. Folia Cardiol. 2015; 10(5): 354-360.
Jose
J, Al-Tamimi FA, Helal MM, Jimmy B, Al Riyami Q. Statin associated
hepatic adverse effects: a retrospective review from a regional
hospital in sultanate of Oman. Oman Med J. 2014; 29(5): 351-357.
Urząd
Rejestracji Produktów Leczniczych, Wyrobów Medycznych i Produktów
Biobójczych. Charakterystyka Produktu Leczniczego: Atorvox 40 mg,
tabletki powlekane. Retrieved April 28, 2025, from
https://leki.urpl.gov.pl/files/77_Atorvox_tabletki_powlekane_40mg.pdf
Dobrowolski
P, Prejbisz A, Kuryłowicz A, Baska A, Burchardt P, Chlebus K, Dzida
G, Jankowski P, Jaroszewicz J, Jaworski P, Kamiński K,
Kapłon-Cieślicka A, Klocek M, Kukla M, Mamcarz A, Mastalerz-Migas
A, Narkiewicz K, Ostrowska L, Śliż D, Tarnowski W, Wolf J, Wyleżoł
M, Zdrojewski T, Banach M, Januszewicz A, Bogdański P. Zespół
metaboliczny – nowa definicja i postępowanie w praktyce.
Stanowisko PTNT, PTLO, PTL, PTH, PTMR, PTMSŻ, sekcji Prewencji
i Epidemiologii PTK, „Klubu 30” PTK oraz sekcji Chirurgii
Metabolicznej i Bariatrycznej TChP. Nadciśnienie Tętnicze
w Praktyce. 2022; 8(2): 47-72.
Shepherd
J, Blauw GJ, Murphy MB, Bollen ELEM, Buckley BM, Cobbe SM, Ford I Gaw
A, Hyland M, Juke- ma JW, Kamper AM, Macfarlane PW, Meinders
AE, Norrie J, Packard CJ, Perry IJ, Stott DJ, Sweeney BJ, Twomey
C, Westendorp RGJ; PROSPER study group. PROspective Study
of Pravastatin in the Elderly at Risk. Pravastatin in
elderly individuals at risk of vascular disease (PROSPER):
a randomised controlled trial. Lancet. 2002; 360(9346):
1623-1630.
MRC/BHF
Heart Protection Study of cholesterol lowering with simvastatin
in 20,536 high-risk individuals: a randomised placebo-controlled
trial. Lancet. 2002; 360(9326): 7-22.
Peixoto
C, Choudhri Y, Francoeur S, McCarthy LM, Fung C, Dowlatshahi D, Lemay
G, Barry A, Goyal P, Pan J, Bjer- re LM, Thompson
W. Discontinuation versus continuation of statins: a systematic
review. J Am Geriatr Soc. 2024; 72(11): 3567-3587.
Lee
SH, Kwon HS, Park YM, Ko SH, Choi YH, Yoon KH, Ahn YB. Statin
discontinuation after achieving a target low density lipoprotein
cholesterol level in type 2 diabetic patients without cardiovascular
disease: a randomized controlled study. Diabetes Metab J. 2014;
38(1): 64-73.
Ageeb
Shahd A, Abdelmoghith A, ElGeed H, Awaisu A, ElMansor A, Owusu
Yaw B. Prevalence, associated risk factors, and adverse
cardiovascular outcomes of statins discontinuation: a systematic
review. Pharmacoepidemiol Drug Safety. 2024; 33(8): e5879.
Pedersen
TR, Faergeman O, Kastelein JJP, Olsson AG, Tikkanen MJ, Holme I,
Larsen ML, Bendiksen FS, Lindahl C, Szarek M, Tsai
J; Incremental Decrease in End Points Through Aggressive Lipid
Lowering (IDEAL) Study Group. High-dose atorvastatin vs usual-dose
simvastatin for secondary prevention after myocardial infarction
the IDEAL Study: a randomized controlled trial. JAMA. 2005;
294(19): 2437-2445.
Copyright: © 2026 Jan Kochanowski University in Kielce This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (http://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.