Smith Bryan A, Wright Charmaine, Davidson Michael
Department of Cardiology, University of Chicago Pritzker School of Medicine, Chicago, IL, USA.
Division of General Internal Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA.
Curr Atheroscler Rep. 2015 Dec;17(12):72. doi: 10.1007/s11883-015-0550-5.
With the goal of decreasing low-density cholesterol (LDL-C) to mitigate risk of both primary and secondary cardiovascular outcomes, statins have been the cornerstone of therapy, significantly reducing the incidence of coronary atherosclerotic vascular disease. Previous studies suggest that adding other non-statin LDL-lowering agents may further lower LDL-C without negative side effects. Recent guidelines support the hypothesis that driving the LDL-C level below previously recommended targets may have a beneficial effect. Ezetimibe, a cholesterol absorption blocker that inhibits the Niemann-Pick C1-Like 1 (NPC1L1) receptor, has been the focus of recent trials that support its use in cardiovascular risk reduction. For patients not at goal on statin therapy alone, ezetimibe has proven to be a safe, well-tolerated medication that may be used as an adjunct to statin therapy to further reduce LDL-C, resulting in a significant mortality benefit.
为了降低低密度脂蛋白胆固醇(LDL-C)以减轻原发性和继发性心血管疾病的风险,他汀类药物一直是治疗的基石,显著降低了冠状动脉粥样硬化性血管疾病的发病率。以往的研究表明,添加其他非他汀类降低LDL的药物可能会进一步降低LDL-C且无不良副作用。最近的指南支持将LDL-C水平降至先前推荐目标以下可能有益的假说。依折麦布是一种抑制尼曼-匹克C1样1(NPC1L1)受体的胆固醇吸收阻滞剂,它是最近一些支持其用于降低心血管疾病风险的试验的焦点。对于仅使用他汀类药物治疗未达目标的患者,依折麦布已被证明是一种安全、耐受性良好的药物,可作为他汀类药物治疗的辅助药物进一步降低LDL-C,从而带来显著的死亡率获益。