动脉样硬化斑块,心血管风险和降脂策略:叙述性审查
Frankie Chor-Cheung Tam1,2, Min-Qing Lin1, Tsun-Ho Lam1,2
1Cardiology Division, Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.
Frontiers in cardiovascular medicine
|January 1, 2026
概括
强烈降低低密度脂蛋白胆固醇 (LDL-C) 通过回归斑块有效降低动脉样硬化心血管疾病 (ASCVD) 风险. 然而,现实世界LDL-C管理中的差距仍然存在,需要改进遵守和早期干预策略.
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.
- 动脉样硬化的发病因子
背景情况:
- 动脉样硬化,ASCVD的主要原因,源于累积低密度脂蛋白胆固醇 (LDL-C) 的暴露.
- 斑块特征显著影响心血管结果和主要心脏不良事件 (MACE).
研究的目的:
- 审查动脉样硬化的发病过程,将风险因素,炎症和脂质与斑块发育联系起来.
- 评估强化降低LDL-C治疗对斑块回归和心血管风险的影响.
- 讨论现实世界脂质管理的挑战和ASCVD预防的新兴策略.
主要方法:
- 关于动脉样硬化病原和脂质管理的当前文献的叙述性综述.
- 分析支持密集的LDL-C降低策略的证据 (他类药物,ezetimibe,PCSK9抑制剂,bempedoic酸).
- 讨论临床实践的差距,坚持问题,以及脂蛋白的作用 (Lp).
主要成果:
- 强烈的LDL-C降低显然会回归斑块,稳定形态,并降低心血管风险.
- 在指南建议和实际实现LDL-C目标之间存在重大差异.
- 升高的Lp (a) 是一个独立的ASCVD风险因素,正在研究有针对性的疗法.
结论:
- 通过密集,早期和个性化干预来优化脂质管理对于减少全球ASCVD负担至关重要.
- 解决治疗惯性,改善坚持性和管理残留风险是提高ASCVD预防的关键.
- 早期检测亚临床动脉样硬化和新的Lp(a) 降低疗法代表了心血管疾病管理的未来方向.
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