Dyslipidemia is the most common, major modifiable risk factor for atherosclerotic coronary artery disease (ASCVD). We have witnessed the statin era for last 30 years and they have emerged as powerful agents both for secondary prevention of ASCVD and primary prevention in high risk patients. They decrease low-density lipoprotein-cholesterol(LDL-C) by 1 mmol and this translates into a reduction of cardiovascular events by 20-24% irrespective of base line LDL-C levels and this is achieved with great safety. Ezetimibe has shown to produce additional decrease in cardiovascular events on top of moderate intensity statin simvastatin in post acute coronary syndrome patients in the IMPROVE IT trial in 2014. The benefit was mainly seen in diabetic patients. In 2015 two fully humanized Proprotein Convertase subtilisin/ kexin 9 monoclonal antibodies (PCSK9 MoAbs), evolocumab and alirocumab were approved for clinical use and they have shown an additional reduction of LDL-C by 1-1 ½ mmol on top of all lipid-lowering therapy including statin and ezetimibie. PCSK9 has now become a validated target after two landmark cardiovascular outcome trials FOURIER and ODYSSEY. They have evoked a new concept of super low LDL (25-50 mg/dl) which has shown incremental benefit with incredible safety in patients with stable ASCVD (FOURIER Trial) and post ACS patients (ODYSSEY Trial) with LDL>70 mg/dL on top of all lipid lowering therapy. These agents are approved for clinical use by several Guidelines for patients of ASCVD with LDL-C > 70 mg/ dL, familial hypercholesterolemia and statin intolerance. Inclisiran which is a small interfering ribonucleic acid has shown a sustained decrease in LDL-C by 50% lasting for 6 months following a single injection It is emerging as a very important competitor for PCSK9 MoAbs. PCSK9 vaccine is a new therapeutic innovation and a single injection decrease LDL by 50% lasting for one year. The animal data is out and human data is keenly awaited. Active interest and research continues unabated in dyslipidemia to further optimize the results and we have not yet reached end of the road.

Aims and Scope:

1. Dyslipidemia
2. Statins
3. Ezetimibe
4. PCSK9 inhibitors
5. Inclisran
6. PCSK9 vaccine