State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.
Clinical Pharmacology Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.
Adv Exp Med Biol. 2020;1177:297-339. doi: 10.1007/978-981-15-2517-9_8.
Cardiovascular disease is the number one cause of human morbidity and mortality worldwide. Although cholesterol-lowering drugs, including statins and recently approved PCSK9 inhibitors, together with antithrombotic drugs have been historically successful in reducing the occurrence of coronary artery disease (CAD), the high incidence of CAD remains imposing the largest disease burden on our healthcare systems. We reviewed cardiovascular drugs recently approved or under clinical development, with a particular focus on their pharmacology and limitations. New agents targeting cholesterol/triglyceride lowering bear promise of further cardiovascular risk reduction. Some new antidiabetic agents show cardiovascular benefit in patients with diabetes. Improved antithrombotic agents with diminished bleeding risk are in clinical development. The recent clinical success of the IL-1β antibody in reducing atherothrombosis opens a new era of therapeutic discovery that targets inflammation. Chinese traditional medicine and cardiac regeneration are also discussed. Human genetics studies of CAD and further delineation of key determinants/pathways underlying the residual risk of CAD under current standard therapy will continue to fuel the pipeline of cardiovascular drug discovery.
心血管疾病是全球范围内导致人类发病率和死亡率的首要原因。尽管降胆固醇药物，包括他汀类药物和最近批准的 PCSK9 抑制剂，以及抗血栓药物在历史上成功地降低了冠状动脉疾病（CAD）的发生，但 CAD 的高发病率仍然给我们的医疗保健系统带来了最大的疾病负担。我们回顾了最近批准或正在临床开发中的心血管药物，特别关注它们的药理学和局限性。针对降低胆固醇/甘油三酯的新型药物有望进一步降低心血管风险。一些新型抗糖尿病药物在糖尿病患者中显示出心血管获益。具有降低出血风险的改良抗血栓药物正在临床开发中。IL-1β 抗体在减少动脉粥样血栓形成方面的近期临床成功开创了一个以炎症为靶点的治疗发现新时代。我们还讨论了中药和心脏再生。CAD 的人类遗传学研究以及对当前标准治疗下 CAD 残余风险的关键决定因素/途径的进一步描述将继续为心血管药物发现提供动力。
