Waters D D
Cardiology Division, Department of Medicine, San Francisco General Hospital, San Francisco, California 94110, USA.
Am J Cardiol. 2001 Aug 16;88(4A):10F-5F. doi: 10.1016/s0002-9149(01)01871-9.
To date, 5 major randomized, placebo-controlled statin trials--the Scandinavian Simvastatin Survival Study, West of Scotland Coronary Prevention Study, Cholesterol and Recurrent Events trial, Long-term Intervention with Pravastatin in Ischaemic Disease, and Air Force/Texas Coronary Atherosclerosis Prevention Study--have convincingly shown that total mortality and major coronary events can be significantly reduced by lowering levels of low-density lipoprotein cholesterol (LDL-C) with statin therapy. These results were achieved in a broad range of patients including those with and without a history of coronary artery disease and with elevated or average LDL-C levels. The results also support the large body of epidemiologic evidence demonstrating that the lower the cholesterol level, the lower the cardiovascular risk. Evidence now substantially supports the urgency of physicians to aggressively target the lowering of LDL-C levels for the primary and secondary prevention of coronary disease.
迄今为止，五项主要的随机、安慰剂对照他汀类药物试验——斯堪的纳维亚辛伐他汀生存研究、苏格兰西部冠心病预防研究、胆固醇与再发事件试验、普伐他汀对缺血性疾病的长期干预研究以及空军/德克萨斯冠状动脉粥样硬化预防研究——已令人信服地表明，通过他汀类药物治疗降低低密度脂蛋白胆固醇（LDL-C）水平可显著降低总死亡率和主要冠状动脉事件。这些结果在广泛的患者群体中得到证实，包括有和没有冠状动脉疾病史以及LDL-C水平升高或处于平均水平的患者。这些结果也支持了大量的流行病学证据，表明胆固醇水平越低，心血管风险越低。目前有充分证据支持医生迫切需要积极将降低LDL-C水平作为冠心病一级和二级预防的目标。
