{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T16:33:30Z","timestamp":1787589210329,"version":"build-2736575974"},"reference-count":59,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>The current treatment of dyslipidemia in patients with cardiovascular risk (CR) is based on three well-defined principles: First, given the extensive evidence demonstrating the association between elevated low-density lipoprotein cholesterol (LDL-C) levels and cardiovascular risk, the primary therapeutic target is LDL-C. Second, as current guidelines recommend LDL-C targets below 55 mg\/dL for high-risk patients, therapeutic goals according to risk level should be achieved as early as possible, and combination therapy is increasingly necessary. Third evidence indicates that non-statin therapies\u2014including ezetimibe, bempedoic acid, PCSK9 inhibitors (evolocumab and alirocumab), and inclisiran\u2014provide substantial LDL-C reductions and reduce cardiovascular events. These agents are particularly effective in very high-risk and statin-intolerant populations, with bempedoic acid addressing both lipid and inflammatory pathways. Additionally, the fixed-dose combination of bempedoic acid and ezetimibe produces an approximately 36.2% reduction in LDL-C in high-risk patients. Risk-stratified guidelines recommend ezetimibe as first-line add-on therapy, followed by PCSK9 inhibitors or bempedoic acid based on residual LDL-C levels and tolerability. Alirocumab has demonstrated a significant reduction in the primary composite endpoint of major adverse cardiovascular events (MACE), with a favorable trend in all-cause mortality. Furthermore, inflammation (measured by hsCRP) provides complementary prognostic information beyond LDL-C. This expert position paper proposes practical algorithms for a precision medicine approach in Latin America, matching treatment intensity to individual risk profiles for the primary and secondary prevention of atherosclerotic cardiovascular disease.<\/jats:p>","DOI":"10.3389\/fmed.2026.1894845","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T15:58:37Z","timestamp":1787587117000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Contemporary non-statin therapies for dyslipidemia management: achieving current lipid targets"],"prefix":"10.3389","volume":"13","author":[{"given":"Carlos I.","family":"Ponte-Negretti","sequence":"first","affiliation":[{"name":"Unidad De Medicina Cardiometab\u00f3lica, Instituto M\u00e9dico La Floresta","place":["Caracas, Venezuela"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Lorenzatti","sequence":"additional","affiliation":[{"name":"Servicio De Cardiolog\u00eda, Fundaci\u00f3n Rusculleda De Investigaci\u00f3n En Medicina, Instituto M\u00e9dico DAMIC","place":["C\u00f3doba, Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Wyss-Quintana","sequence":"additional","affiliation":[{"name":"Unidad De Cardiolog\u00eda Cardio Solutions","place":["Guatemala City, Guatemala"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo","family":"Alonso","sequence":"additional","affiliation":[{"name":"Unidad Cardiovascular, Centro Avanzado De Medicina Metab\u00f3lica y Nutrici\u00f3n","place":["Santiago, Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00e1xima","family":"M\u00e9ndez-Castillo","sequence":"additional","affiliation":[{"name":"Unidad De L\u00edpidos, Cl\u00ednica De L\u00edpidos CLL LIPID","place":["Santo Domingo, Dominican Republic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osiris","family":"Valdez-Tiburcio","sequence":"additional","affiliation":[{"name":"Departamento De Cardiolog\u00eda, Hospital Central Romana","place":["La Romana, Dominican Republic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladimir E.","family":"Ullauri-Sol\u00f3rzano","sequence":"additional","affiliation":[{"name":"Departamento De Cardiolog\u00eda, Hospital Metropolitano","place":["Quito, Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camila Y.","family":"Ullauri-Valc\u00e1rcel","sequence":"additional","affiliation":[{"name":"Unitat De Recerca, Cl\u00ednic BarceLona-Institut d\u2019Investigacions Biom\u00e8diques August Pi Sunyer (IDIBAPS)","place":["Barce-Lona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Puente-Barrag\u00e1n","sequence":"additional","affiliation":[{"name":"Departamento De Cardiolog\u00eda, Hospital Centro M\u00e9dico Nacional 20 De Noviembre, Instituto De Seguridad y Ser-Vicios Sociales De Los Trabajadores Del Estado","place":["Mexico City, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luz C.","family":"Z\u00e1rate-Correa","sequence":"additional","affiliation":[{"name":"Unidad De Cardiolog\u00eda, CardioDec","place":["Cali, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 G.","family":"Prieto-Mar\u00edn","sequence":"additional","affiliation":[{"name":"One Health Research Group, Universidad De Las Americas","place":["Quito, Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac A. 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