{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T01:25:29Z","timestamp":1794014729392,"version":"4.8.0"},"reference-count":117,"publisher":"The Endocrine Society","issue":"9","funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute (to","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Statins are the lipid-lowering therapy of choice for the prevention of atherosclerotic cardiovascular disease (ASCVD) but their effectiveness in lowering low-density lipoprotein cholesterol (LDL-C) can substantially differ between individuals. In this mini-review, we describe the different causes for a suboptimal statin response and an algorithm for the diagnosis and clinical management of these patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Evidence Acquisition<\/jats:title>\n                    <jats:p>A PubMed search using the terms \u201cstatin resistance,\u201d \u201cstatin sensitivity,\u201d \u201cstatin pharmacokinetics,\u201d \u201ccardiovascular disease,\u201d and \u201clipid-lowering therapies\u201d was performed. Published papers in the past 10 years that were relevant to the topic were examined to provide content for this mini-review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Evidence Synthesis<\/jats:title>\n                    <jats:p>Suboptimal lowering of LDL-C by statins is a major problem in the clinical management of patients and limits the value of this therapeutic approach. There are multiple causes of statin hyporesponsiveness with compliance being the most common explanation. Other causes, such as analytical issues with LDL-C measurement and the presence of common lipid disorders (familial hypercholesterolemia, elevated lipoprotein[a] and secondary dyslipidemias) should be excluded before considering primary statin resistance from rare genetic variants in lipoprotein-related or drug-metabolism genes. A wide variety of nonstatin lipid-lowering drugs are now available and can be added to statins to achieve more effective LDL-C lowering.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The evaluation of statin hyporesponsiveness is a multistep process that can lead to the optimization of lipid-lowering therapy for the prevention of ASCVD. It may also lead to the identification of distinct types of dyslipidemias that require specific therapies and\/or the genetic screening of family members.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgad153","type":"journal-article","created":{"date-parts":[[2023,3,17]],"date-time":"2023-03-17T09:25:15Z","timestamp":1679045115000},"page":"2424-2434","source":"Crossref","is-referenced-by-count":21,"title":["Approach to the Patient With a Suboptimal Statin Response: Causes and Algorithm for Clinical Management"],"prefix":"10.1210","volume":"108","author":[{"given":"Lufan","family":"Sun","sequence":"first","affiliation":[{"name":"Department of Cardiology, The First Hospital of China Medical University , Shenyang 110001 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9479-0741","authenticated-orcid":false,"given":"Anna","family":"Wolska","sequence":"additional","affiliation":[{"name":"Lipoprotein Metabolism Laboratory, Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health , Bethesda, MD 20892 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo","family":"Amar","sequence":"additional","affiliation":[{"name":"Lipoprotein Metabolism Laboratory, Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health , Bethesda, MD 20892 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Zubir\u00e1n","sequence":"additional","affiliation":[{"name":"Departamento de Endocrinolog\u00eda y Metabolismo de L\u00edpidos, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n , Mexico City 14080 , Mexico"},{"name":"Unidad de Investigaci\u00f3n de Enfermedades Metab\u00f3licas, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n , Mexico City 14080 , 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