伴随性疾病患者的脱脂血症的管理:面对挑战
Gert Mayer1, Dobromir Dobrev2,3,4, Juan Carlos Kaski5
1Department of Internal Medicine IV (Nephrology and Hypertension) Medical University Innsbruck, Austria.
European heart journal. Cardiovascular pharmacotherapy
|August 17, 2024
概括
失脂血症在慢性病 (CKD) 患者中显著增加心血管风险. 对于大多数人来说,建议服用他类药物,而其他降脂药物则需要对安全性和有效性的个性化评估.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 失脂症在慢性病 (CKD) 中很普遍,增加了心血管死亡风险.
- 复杂的病理生理学受到糖尿病和蛋白尿等并发症的影响.
研究的目的:
- 对非透析CKD患者的失脂症的当前治疗选择进行审查.
- 评估各种降脂疗法在CKD中的疗效和安全性.
主要方法:
- 文献综述,重点关注慢性脏病中的失脂症管理.
- 对他类药物,PCSK9抑制剂,bempedoic酸,inclisiran,纤维酸和icosapent乙烯的分析.
- 排除接受替代疗法的患者.
主要成果:
- 类他类药物是安全的和推的;LDL胆固醇目标因指导方针而异.
- 在二次分析中,PCSK9抑制剂显示出潜在的,没有观察到CKD对效果的修改.
- 在CKD中,bempedoic acid和inclisiran的有效性和安全性数据有限;纤维酸和icosapent ethyl需要进一步研究.
结论:
- 应在几乎所有慢性病患者中启动他类药物治疗,以减少心血管事件.
- 其他降脂剂需要仔细,个性化考虑,因为在CKD人群中不清楚的疗效和安全性数据.
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