脱脂症和周围动脉疾病
Ajay Yadav1, Vivek Sawant1, Varinder Singh Bedi1
1Institutions: Sir Ganga Ram Hospital, India.
Indian heart journal
|January 15, 2024
概括
周围动脉疾病 (PAD) 影响12%的成年人,并增加心血管死亡风险. 降脂疗法是有前途的,但需要研究它们对PAD患者肢体挽救的影响.
科学领域:
- 心脏病学 心脏病学
- 血管医学 血管医学
- 公共卫生 公共卫生
背景情况:
- 周围动脉疾病 (PAD) 影响全球12%的成人人口,患病率不断增加.
- 多血管性疾病,涉及多动脉床 (CAD,中肠/脏,心血管疾病) 的动脉样硬化PAD是常见的,影响到REACH注册表中的6个患者中的1个.
- 在PAD患者中,进展至关键四肢缺血症 (CLI) 的风险增加了心血管死亡的10到15倍.
研究的目的:
- 对包括PAD在内的非常高风险患者的失脂血症的当前管理策略进行审查.
- 要突出降脂剂的有效性,如他类药物,ezetimibe,和PCSK9抑制剂在减少心血管事件.
- 强调印度需要一个多学科工作组来调查降脂剂对肢体救援和PAD主要肢体事件的影响.
主要方法:
- 对PAD,多血管疾病和降脂疗法的现有文献和临床试验数据的审查.
- 对高风险人群中脱脂症管理的指导方针建议的分析.
- 检查来自REACH等注册表的数据,以及IMPROVE-IT和FOURIER等试验.
主要成果:
- 在PAD患者中,高强度的他类药物治疗显著降低了全因死亡率,心血管死亡率,心血管结果,中风,急性四肢缺血症和截肢.
- 结合治疗以乙胺和他类药物 (IMPROVE-IT) 进一步减少主要心血管不良事件 (MACE).
- PCSK9抑制剂显示了初级终点的降低,与非PAD患者相比,PAD患者的显著益处 (3.5%与FOURIER试验中的1.6%相比).
结论:
- 在PAD患者中最优化治疗脱脂症仍然是一个挑战,尽管已经证明了降脂剂的好处.
- 在印度,有必要进行专注的研究,以了解降脂疗法对肢体救援和PAD肢体相关事件的直接影响.
- 建立印度多学科工作组对于推动研究和改善PAD患者的治疗结果至关重要.
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