Johns Hopkins Ciccarone Preventive Cardiology Center, Johns Hopkins University School of Medicine, Baltimore, USA.
Curr Opin Cardiol. 2010 Sep;25(5):502-12. doi: 10.1097/HCO.0b013e32833cd474.
Novel research over the past 2 years has necessitated an update of our 'ABCDE' approach to the metabolic syndrome.
Clinical trials investigating the role of aspirin in primary prevention have led to an adjustment in the indication for aspirin in metabolic syndrome patients at intermediate risk of a cardiovascular event. There has been renewed enthusiasm for the use of niacin as second-line treatment for atherogenic dyslipidemia, with fibrates reserved for those with severe residual dyslipidemia. In light of the noteworthy findings of the Justification for the Use of statins in Primary Prevention: an Intervention Trial Evaluating Rosuvastatin trial, the 'C' category representing 'cholesterol' has been expanded to include the use of high-sensitivity C-reactive protein for guiding statin use and perhaps monitoring statin therapy. Recent evidence confirms that diet and exercise continue to be the cornerstone of any metabolic syndrome treatment strategy.
The revised 'ABCDE' approach incorporates the most recent influential studies into a simple yet thorough algorithm for management of the metabolic syndrome.
过去 2 年的新研究需要更新我们代谢综合征的“ABCDE”方法。
阿司匹林在一级预防中的作用的临床试验导致对代谢综合征患者中具有心血管事件中等风险的患者使用阿司匹林的适应证进行了调整。人们对烟酸作为致动脉粥样硬化性血脂异常的二线治疗重新产生了兴趣，而对于严重残余血脂异常的患者则保留使用贝特类药物。鉴于“他汀类药物在初级预防中的应用的理由：评估瑞舒伐他汀的试验”的重要发现，代表“胆固醇”的“C”类别已扩大到包括使用高敏 C 反应蛋白来指导他汀类药物的使用，甚至可能监测他汀类药物的治疗。最近的证据证实，饮食和运动仍然是任何代谢综合征治疗策略的基石。
经过修订的“ABCDE”方法将最新的有影响力的研究纳入了一个简单而全面的代谢综合征管理算法中。
