Weill Cornell Medical College, New York, New York 10021, USA.
Am J Cardiol. 2012 Jul 1;110(1 Suppl):3A-14A. doi: 10.1016/j.amjcard.2012.04.002.
Strategies to reduce cardiovascular risk in primary and secondary prevention focus on optimization of low-density lipoprotein (LDL) cholesterol levels. Since the 2004 update of the Adult Treatment Panel (ATP) III guidelines, developments in the field of preventive cardiology have included new guidelines for women and for familial hypercholesterolemia; a risk assessment algorithm incorporating the inflammatory marker high-sensitivity C-reactive protein (hsCRP); and clinical trial data confirming the efficacy of aggressive lipid management. Within secondary prevention in particular, there is a need for more widespread use of intensive statin therapy to achieve low LDL cholesterol levels to reduce cardiovascular morbidity and mortality in patients at high risk for recurrent events. Within primary prevention, individuals with diabetes mellitus, mixed dyslipidemia, or elevated hsCRP also are at increased risk and may warrant treatment with aggressive lipid-modifying therapy. In this article, we provide an update on recent guidelines, risk algorithms, and trials related to the prevention and treatment of coronary artery disease.
在一级和二级预防中降低心血管风险的策略侧重于优化低密度脂蛋白（LDL）胆固醇水平。自 2004 年成人治疗专家组（ATP）III 指南更新以来，预防心脏病学领域的发展包括了针对女性和家族性高胆固醇血症的新指南；包含炎症标志物高敏 C 反应蛋白（hsCRP）的风险评估算法；以及临床试验数据证实了积极的血脂管理的疗效。特别是在二级预防中，需要更广泛地使用强化他汀类药物治疗来实现低 LDL 胆固醇水平，以降低复发性事件高危患者的心血管发病率和死亡率。在一级预防中，患有糖尿病、混合性血脂异常或 hsCRP 升高的个体也存在更高的风险，可能需要进行积极的降脂治疗。在本文中，我们提供了与冠心病预防和治疗相关的最新指南、风险算法和试验的更新。
