Nass C M, Wiviott S D, Allen J K, Post W S, Blumenthal a R
The Johns Hopkins University School of Medicine, Division of Cardiology, Johns Hopkins Hospital, 600 N. Wolfe Street, Carnegie 538, Baltimore, MD 21287, USA.
Curr Cardiol Rep. 2000 Sep;2(5):424-32. doi: 10.1007/s11886-000-0056-8.
Randomized clinical trials have established that lipid- lowering pharmacologic therapy can substantially reduce morbidity and mortality in patients with known coronary artery disease (CAD). Researchers are now working to define the role of lipid-lowering agents in the primary prevention of CAD to extend their benefit to patients at increased risk for future coronary events. The risk assessment models presently used for secondary prevention are not sufficient to identify high-risk, asymptomatic patients. Building on the accumulated data about the physiologic mechanisms and metabolic factors that contribute to CAD, novel serum markers and diagnostic tests are being critically studied to gauge their utility for the assessment of high-risk patients and occult vascular disease. New risk prediction models that combine traditional risk factors for CAD with the prudent use of new screening methods will allow clinicians to target proven risk reduction therapies at high-risk patients before they experience a cardiac event.
随机临床试验已经证实，降脂药物治疗可显著降低已知冠状动脉疾病（CAD）患者的发病率和死亡率。研究人员目前正在努力确定降脂药物在CAD一级预防中的作用，以便将其益处扩展到未来发生冠状动脉事件风险增加的患者。目前用于二级预防的风险评估模型不足以识别高危无症状患者。基于有关导致CAD的生理机制和代谢因素的累积数据，正在严格研究新型血清标志物和诊断测试，以评估它们在评估高危患者和隐匿性血管疾病方面的效用。将CAD的传统风险因素与谨慎使用新筛查方法相结合的新风险预测模型，将使临床医生能够在高危患者发生心脏事件之前，针对已证实的风险降低疗法进行治疗。
