Gonzalez Lorena, Helkin Alex, Gahtan Vivian
Department of Veterans Affairs Healthcare Network Upstate New York at Syracuse, Syracuse, NY, USA Department of Surgery, SUNY Upstate Medical University, Syracuse, NY, USA.
Department of Veterans Affairs Healthcare Network Upstate New York at Syracuse, Syracuse, NY, USA Department of Surgery, SUNY Upstate Medical University, Syracuse, NY, USA
Vasc Endovascular Surg. 2016 Feb;50(2):119-35. doi: 10.1177/1538574416628655.
Dyslipidemia is one of the major modifiable risk factors associated with atherosclerotic cardiovascular disease. Appropriate modification of lipid profiles reduces the progression of atherosclerosis in vessel walls across all vascular beds. The management of dyslipidemia has evolved over the last several decades, especially since the discovery of 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors, also known as statins. Statin use in atherosclerotic heart disease is well described in observational and prospective placebo-controlled studies, citing both lipid-lowering and pleiotropic effects. However, the effect of statins and other lipid-lowering agents on noncoronary arterial beds (the aorta, arteries to the extremities, renal, and carotid arteries) is less understood. This article is part 2 of a 2-part review, with part 1 having focused on lipid metabolism and the downstream effects of lipids on the development of atherosclerosis. The current review (part 2) will discuss trials, retrospective reviews, and observational cohort studies regarding the use of statins and/or other lipid-lowering drugs for primary and secondary prevention of peripheral noncoronary atherosclerotic disease.
血脂异常是与动脉粥样硬化性心血管疾病相关的主要可改变危险因素之一。适当改善血脂水平可减缓所有血管床血管壁动脉粥样硬化的进展。在过去几十年中,血脂异常的管理方法不断演变,尤其是自发现3-羟基-3-甲基戊二酰辅酶A还原酶抑制剂(即他汀类药物)以来。在观察性研究和前瞻性安慰剂对照研究中,他汀类药物在动脉粥样硬化性心脏病中的应用已有充分描述,这些研究提到了其降脂作用和多效性作用。然而,他汀类药物和其他降脂药物对非冠状动脉床(主动脉、四肢动脉、肾动脉和颈动脉)的影响尚不清楚。本文是一篇分两部分的综述的第2部分,第1部分重点介绍了脂质代谢以及脂质对动脉粥样硬化发展的下游影响。当前这篇综述(第2部分)将讨论关于使用他汀类药物和/或其他降脂药物进行外周非冠状动脉粥样硬化疾病一级和二级预防的试验、回顾性综述和观察性队列研究。