Campbell Catherine Y, Rivera Juan J, Blumenthal Roger S
Johns Hopkins Ciccarone Preventive Cardiology Center, Blalock 524C, 600 North Wolfe Street, Baltimore, MD 21287, USA.
Curr Cardiol Rep. 2007 Nov;9(6):499-505. doi: 10.1007/BF02938395.
Statin therapy for aggressive low-density lipoprotein cholesterol (LDL-C) reduction reduces cardiovascular morbidity and mortality. However, even on maximal statin therapy, high-risk patients have substantial residual risk of coronary heart disease (CHD). Certain subgroups, such as individuals with diabetes mellitus, low high-density lipoprotein cholesterol (HDL-C), metabolic syndrome, or other comorbidities, have a particularly high residual risk. Patients at high risk for future CHD events often require multiple aggressive risk-reduction therapies (eg, antiplatelet agents, an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, beta-blockade, cholesterol and/or diabetes management, and lifestyle interventions) to further lower their overall cardiovascular risk. For cholesterol management, combination therapy may be required to attain optimal levels of LDL-C, HDL-C, and non-HDL-C.
他汀类药物疗法用于积极降低低密度脂蛋白胆固醇（LDL-C）可降低心血管疾病的发病率和死亡率。然而，即使采用最大剂量的他汀类药物治疗，高危患者仍有相当大的冠心病（CHD）残余风险。某些亚组，如患有糖尿病、高密度脂蛋白胆固醇（HDL-C）水平低、代谢综合征或其他合并症的个体，残余风险尤其高。未来发生冠心病事件风险高的患者通常需要多种积极的风险降低疗法（如抗血小板药物、血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂、β受体阻滞剂、胆固醇和/或糖尿病管理以及生活方式干预）来进一步降低其总体心血管风险。对于胆固醇管理，可能需要联合治疗以达到LDL-C、HDL-C和非HDL-C的最佳水平。
