Average LDL-C reduction with lipid-lowering therapies (ESC/EAS)

Average LDL-C reduction with lipid-lowering therapies (ESC/EAS):

■ Statins are the foundation:

Moderate-intensity ≈ 30%

High-intensity ≈ 50%

■ Statin + non-statin combinations markedly improve efficacy:

High-intensity statin + ezetimibe ≈ 60%

High-intensity statin + bempedoic acid ≈ 58%

■ PCSK9 inhibitors provide the largest incremental effect:

PCSK9 mAb alone ≈ 60%

With statins ± ezetimibe → 75–80%

■ Maximal LDL-C lowering (~85–86%) is achieved with quadruple therapy

(high-intensity statin + ezetimibe + bempedoic acid + PCSK9 mAb).

■ Clinical implication: very-high-risk patients usually require early combination therapy to reach ESC LDL-C targets.

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