Cardiovascular Division, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.
Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
J Clin Lipidol. 2017 Jul-Aug;11(4):880-890. doi: 10.1016/j.jacl.2017.05.001. Epub 2017 May 19.
An Expert Panel convened by the National Lipid Association was charged with updating the recommendations on the use of proprotein convertase subtilisin/kexin type 9 (PCSK9) antibody therapy that were provided by the 2015 National Lipid Association Recommendations for the Patient-Centered Management of Dyslipidemia: Part 2. Recent studies have demonstrated the efficacy of these agents in reducing low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol and have confirmed their excellent safety profile. A cardiovascular outcomes study has shown that these agents reduce incident atherosclerotic cardiovascular disease (ASCVD) events in patents with stable ASCVD and concomitant risk factors. The current update provides the Expert Panel's evidence-based recommendations on the clinical utility of PCSK9 inhibitors in patients with stable ASCVD, progressive ASCVD, LDL-C ≥ 190 mg/dL (including polygenic hypercholesterolemia, heterozygous familial hypercholesterolemia and the homozygous familial hypercholesterolemia phenotype) and very-high-risk patients with statin intolerance.
一个由国家脂质协会召集的专家小组负责更新 2015 年国家脂质协会提出的以患者为中心的血脂异常管理建议的第 2 部分中关于前蛋白转化酶枯草溶菌素/柯萨奇蛋白酶 9(PCSK9)抗体治疗的建议。最近的研究表明,这些药物在降低低密度脂蛋白胆固醇和非高密度脂蛋白胆固醇方面非常有效,并证实了它们出色的安全性。一项心血管结局研究表明,这些药物可降低稳定型动脉粥样硬化性心血管疾病(ASCVD)患者和同时存在危险因素患者的动脉粥样硬化性心血管疾病(ASCVD)事件的发生率。本更新版提供了专家小组关于 PCSK9 抑制剂在稳定型 ASCVD、进展性 ASCVD、LDL-C≥190mg/dL(包括多基因高胆固醇血症、杂合子家族性高胆固醇血症和纯合子家族性高胆固醇血症表型)和他汀类药物不耐受的极高危患者中临床应用的循证推荐。
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