PONE-D-21-11502

Determining propensity for sub-optimal low-density lipoprotein cholesterol response to statins and future risk of cardiovascular disease

PLOS ONE

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Review Comments to the Author

Reviewer #1: I’ve read with attention the paper of Ralph Kwame Akyea et al. that is potentially of interest. The background and aim of the study have been clearly defined. The methodology applied is overall correct and the results are reliable. I’ve only some minor comments: - The difference in use of low intensity statin in the two cohort could be influenced by the fact that Asian are more sensible to statin-side effects and some drugs are to be used at lower dosages in Asians

- The authors stress that ezetimibe should be used in secundary prevention patients only... why? The guidelines suggest to add ezetimibe where LDL-C target is not achieved, in high-risk patients in primary prevention as well

- The authors suggest the use of icosapent ethyl as an adjunct to diet in adults with triglycerides of at least 500 mg/dL. This is not supported by the reference chosen by the authors nor it is supported by any guideline. Probably fenofibrate should be considered as well.

Determining propensity for sub-optimal low-density lipoprotein cholesterol response to statins and future risk of cardiovascular disease

PONE-D-21-11502R1

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Kind regards,

Carmine Pizzi

Academic Editor

PLOS ONE