动脉样硬化残留脂质风险-现有和未来药物治疗的概述
Muntaser Omari1, Mohammad Alkhalil1,2
1Cardiothoracic Centre, Freeman Hospital, Newcastle-upon-Tyne NE7 7DN, UK.
Journal of cardiovascular development and disease
|April 26, 2024
概括
动脉样硬化疾病中的残留心血管风险与脂蛋白有关. 虽然低密度脂蛋白胆固醇 (LDL-c) 是关键的,但像脂蛋白 (a) 这样的新兴标记物可能会提供新的治疗点.
科学领域:
- 心血管医学 心血管医学
- 脂质学 脂质学是指脂质学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 患有动脉样硬化疾病的患者尽管接受最佳治疗,但仍面临心血管残留风险.
- 脂蛋白颗粒及其含量显著影响未来的心血管事件.
- 低密度脂蛋白胆固醇 (LDL-c) 是动脉样硬化发展的一个确定的因果因素.
研究的目的:
- 审查目前针对动脉样硬化疾病的脂质生物标志物的治疗方法.
- 探索各种脂蛋白在心血管风险中的机械作用.
- 为了确定超出LDL-c.潜在的新治疗点.
主要方法:
- 对脂质修饰疗法的临床试验数据和机制研究的审查.
- 对脂质代谢的遗传研究进行分析,包括孟德尔随机化.
- 评估新出现的脂质生物标志物及其与心血管事件的关联.
主要成果:
- 类他类药物,ezetimibe,PCSK9抑制剂和bempedoic酸证实了LDL-c的作用.
- 提高HDL-c的疗法和降低甘油三的药物 (纤维酸,EPA) 并没有持续降低心血管风险.
- 新兴的标记物,如脂蛋白 (a) 和胆固醇排泄能力,显示出降低风险的潜力.
结论:
- 向LDL-c仍然至关重要,但残留风险仍然存在.
- 甘油三的作用是复杂的,正在进行对新药物的研究.
- 新型脂质生物标志物可能在与现有疗法结合时提供额外的好处.
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