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Lipids Management Critical in Preventive Cardiology

Lifestyle, pharmacologic interventions help patients with dyslipidemia

Cholesterol molecules

A specialist in preventive cardiology, Nishant Shah, MD, provides advanced lipid management to patients with dyslipidemia, recommending therapies ranging from patient-specific lifestyle modifications to pharmacologic interventions.

At the Duke Cardiometabolic Prevention Clinic, Shah works with multiple specialists to promote proactive cholesterol monitoring and management, with an emphasis on high-risk patients with existing cardiovascular disease (CVD), patients with high genetic risk, and patients with multiple risk factors for CVD.

Although his practice is based on well-established cholesterol guidelines, Shah says it is also important to keep in mind patient-specific characteristics. “We certainly work toward guideline-based goals that are important to achieve, but there’s also an art in our approach. It’s important to listen to an individual’s personal story to determine how best we can achieve those goals and help lower the risk of heart disease,” Shah says.

“My goal is to reach out to as many patients as possible to help identify their individual risk and make recommendations to help them live heart healthy,” he adds.

Shah is also involved in research to advance the understanding of complex cholesterol disease. One focus of his research is lipoprotein(a), a biomarker identified as an atherosclerotic disease risk factor and contributor to premature coronary heart disease and stroke.

Lipoprotein(a), which has a genetic origin, is elevated in about 20% of the population. No targeted therapies are available for lipoprotein(a), but preventive cardiologists like Shah work to help reduce the CVD risk for patients with elevated levels. Shah predicts that more targeted treatments will be developed soon as research advances. If warranted, Shah and colleagues also monitor several other biomarkers beyond the basic, traditional cholesterol measures when stratifying the risk for patients.