更具侵略性的LDL-胆固醇标和心血管疾病预防治疗方法的演变
Jeffrey E Jones1, Kevin S Tang1, Ailin Barseghian1
1Heart Disease Prevention Program, C240 Medical Sciences, Division of Cardiology, Department of Medicine, University of California, Irvine, CA 92697, USA.
Journal of clinical medicine
|December 9, 2023
概括
降低低密度脂蛋白胆固醇 (LDL-C) 的目标,特别是对于动脉样硬化心血管疾病 (ASCVD) 患者,得到了新疗法的支持. 证据指导了目前对脂质管理的临床建议.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 预防医学 预防医学
背景情况:
- 50年来,脂质管理的治疗范式在不断发展.
- 在高风险患者中,越来越多地关注激进的低密度脂蛋白胆固醇 (LDL-C) 降低.
- 动脉样硬化心血管疾病 (ASCVD) 的流行需要先进的降脂策略.
研究的目的:
- 审查脂质管理和治疗干预措施的历史趋势.
- 检查目前的证据支持临床指南中较低的LDL-C目标.
- 讨论新型非他类药物治疗在管理残留ASCVD风险中的作用.
主要方法:
- 关于心血管结局试验的综合文献综述.
- 对脂质标的临床指南和建议的分析.
- 评估他类药物和非他类药物疗法的疗效.
主要成果:
- 立方体治疗,特别是高强度治疗,在减少ASCVD结局方面表现出显著的有效性.
- 非他类药物治疗 (ezetimibe,PCSK9抑制剂,bempedoic酸) 进一步降低ASCVD风险.
- 新出现的证据支持更严格的LDL-C目标来管理残留风险.
结论:
- 目前的证据支持一种积极的方法来降低LDL-C.
- 新的治疗方案使临床医生能够实现更低的LDL-C目标.
- 指南越来越多地反映了对高风险人群加强脂质管理的需要.
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