Jean Charles FruchartJean DavignonMichel P. HermansKhalid Al-RubeaanPierre AmarencoGerd AssmannPhilip BarterJohn BetteridgeEric BruckertAda CuevasMichel FarnierEle FerranniniPaola FiorettoJacques GenestHenry N. GinsbergAntonio M. GottoDayi HuTakashi KadowakiTatsuhiko KodamaMichel KrempfYuji MatsuzawaJesús M. Núñez-CortésCarlos C. MonfilHisao OgawaJorge PlutzkyDaniel J. RaderShaukat SadikotRaul D. SantosEvgeny ShlyakhtoPiyamitr SritaraRody SyAlan TallChee E. TanLale TokgözoǧluPeter P. TothPaul ValensiChristoph WannerAlberto ZambonJunren ZhuPaul ZimmetR3i FoundationFondation coeur et arteresInstitut de Recherches Cliniques de MontrealCliniques Universitaires Saint-Luc, BrusselsKing Saud UniversityHopital Bichat-Claude-Bernard AP-HPAssmann-Stiftung für PräventionUniversity of New South Wales (UNSW) AustraliaUCLHopital Universitaire Pitie SalpetriereClinica Las CondesPoint MedicalUniversita di PisaUniversita degli Studi di PadovaMcGill University Health Centre, Royal Victoria HospitalColumbia University in the City of New YorkWeill Cornell Medical CollegePeking UniversityUniversity of TokyoCentre Hospitalier Universitaire de NantesOsaka UniversityHospital General Universitario Gregorio MaranonUniversity of ConcepcionKumamoto UniversityBrigham and Women's Hospital and Harvard Medical SchoolPenn Cardiovascular InstituteJaslok Hospital and Research CentreInstituto do Coracao do Hospital das ClinicasAlmazov National Medical Research CentreMahidol UniversityUniversity of the Philippines ManilaColumbia University, College of Physicians and SurgeonsGleneagles HospitalHacettepe UniversitesiUniversity of IllinoisUniversite Paris 13Universitatsklinikum WurzburgFudan UniversityBaker Heart and Diabetes Institute2018-11-092018-11-092014-01-24Cardiovascular Diabetology. Vol.13, No.1 (2014)147528402-s2.0-84892772956https://repository.li.mahidol.ac.th/handle/123456789/34316Cardiovascular disease poses a major challenge for the 21st century, exacerbated by the pandemics of obesity, metabolic syndrome and type 2 diabetes. While best standards of care, including high-dose statins, can ameliorate the risk of vascular complications, patients remain at high risk of cardiovascular events. The Residual Risk Reduction Initiative (R3i) has previously highlighted atherogenic dyslipidaemia, defined as the imbalance between proatherogenic triglyceride-rich apolipoprotein B-containing-lipoproteins and antiatherogenic apolipoprotein A-I-lipoproteins (as in high-density lipoprotein, HDL), as an important modifiable contributor to lipid-related residual cardiovascular risk, especially in insulin-resistant conditions. As part of its mission to improve awareness and clinical management of atherogenic dyslipidaemia, the R3i has identified three key priorities for action: i) to improve recognition of atherogenic dyslipidaemia in patients at high cardiometabolic risk with or without diabetes; ii) to improve implementation and adherence to guideline-based therapies; and iii) to improve therapeutic strategies for managing atherogenic dyslipidaemia. The R3i believes that monitoring of non-HDL cholesterol provides a simple, practical tool for treatment decisions regarding the management of lipid-related residual cardiovascular risk. Addition of a fibrate, niacin (North and South America), omega-3 fatty acids or ezetimibe are all options for combination with a statin to further reduce non-HDL cholesterol, although lacking in hard evidence for cardiovascular outcome benefits. Several emerging treatments may offer promise. These include the next generation peroxisome proliferator-activated receptorα agonists, cholesteryl ester transfer protein inhibitors and monoclonal antibody therapy targeting proprotein convertase subtilisin/kexin type 9. However, long-term outcomes and safety data are clearly needed. In conclusion, the R3i believes that ongoing trials with these novel treatments may help to define the optimal management of atherogenic dyslipidaemia to reduce the clinical and socioeconomic burden of residual cardiovascular risk. © 2014 Fruchart et al.; licensee BioMed Central Ltd.Mahidol UniversityMedicineReviewSCOPUS10.1186/1475-2840-13-26