有些人希望LDL胆固醇为零
Claudio Borghi1, Alessio Bragagni1
1Department of Medical and Surgical Sciences, University of Bologna, Bologna.
概括
降低LDL胆固醇 (LDLc) 可以显著降低心血管风险. 本综述探讨了通过先进疗法实现极低的LDLc水平的安全性和有效性,甚至接近零.
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:
- 降低的LDL胆固醇 (LDLc) 和降低心血管 (CV) 风险之间的确立联系.
- 在心血管疾病管理和初级预防中逐步降低治疗性LDLc目标.
- 出现PCSK9抑制剂,使LDLc减少超过当前指南目标.
研究的目的:
- 审查关于降低LDLc的"越低越好"范式的科学证据.
- 调查使用极低的LDLc水平进一步降低心血管风险的潜力.
- 评估用于极端LDLc降低的多药疗法的安全性.
主要方法:
- 对LDLc降低和心血管结果研究的综合文献综述.
- 分析涉及PCSK9抑制剂和其他降脂疗法的临床试验数据.
- 评估与密集的LDLc降低策略相关的安全概况.
主要成果:
- 证据支持持续的LDLc降低与心血管风险降低相关.
- PCSK9抑制剂促进了前所未有的LDLc水平降低.
- 极端降低LDLc的安全数据需要持续评估,特别是多疗法.
结论:
- 对LDLc的"越低越好"方法得到了当前证据的支持.
- 达到接近零的LDLc水平可能会进一步降低心血管风险.
- 当使用多种疗法以极端降低LDLc时,仔细监测安全性至关重要.
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