Jia Xiaoming, Lorenz Patrick, Ballantyne Christie M
BAYLOR COLLEGE OF MEDICINE, HOUSTON, TEXAS.
Methodist Debakey Cardiovasc J. 2019 Jan-Mar;15(1):32-38. doi: 10.14797/mdcj-15-1-32.
Low-density lipoprotein cholesterol (LDL-C) is a well-established risk factor for atherosclerotic cardiovascular disease (ASCVD). Statins remain the first-line therapy for patients with elevated LDL-C and increased risk. However, many at-risk patients do not achieve adequate LDL-C lowering with statin monotherapy or do not tolerate statins because of side effects. Recent cardiovascular outcome trials involving ezetimibe and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors have demonstrated efficacy of nonstatin therapies in further reducing LDL-C levels and ASCVD risk. This review highlights the available nonstatin therapeutic options and explores important novel therapeutic approaches currently under development.
低密度脂蛋白胆固醇（LDL-C）是动脉粥样硬化性心血管疾病（ASCVD）公认的危险因素。他汀类药物仍然是LDL-C升高且风险增加患者的一线治疗药物。然而，许多高危患者使用他汀类药物单药治疗无法充分降低LDL-C水平，或者由于副作用而不耐受他汀类药物。最近涉及依折麦布和前蛋白转化酶枯草溶菌素/kexin 9型（PCSK9）抑制剂的心血管结局试验证明了非他汀类疗法在进一步降低LDL-C水平和ASCVD风险方面的疗效。本综述重点介绍了现有的非他汀类治疗选择，并探讨了目前正在研发的重要新型治疗方法。
