Wallemacq C, Paquot N
) Service de Diabétologie, Nutrition et Maladies métaboliques, CHU Liège, Belgique.
Rev Med Liege. 2020 May;75(5-6):386-391.
Over the past 10 years, meta-analyzes of statins, randomized clinical trials using ezetimibe and anti-PCSK9 antibodies, and Mendelian randomization studies have strengthened the central and causal role of LDL-c in the development of cardiovascular disease. The LDL-c target has been gradually lowered and to date there is no LDL-c threshold below which the benefit of the reduction disappears. The decrease in cardiovascular risk is proportional to the absolute reduction in the concentration of LDL-c regardless of the means by which this reduction is obtained. These data led to the formulation of new guidelines for the management of dyslipidemias relating in particular to a lowering of the LDL-c target and to the complementary use of ezetimibe and anti-PCSK9 antibodies after statins.
在过去10年中，对他汀类药物的荟萃分析、使用依折麦布和抗PCSK9抗体的随机临床试验以及孟德尔随机化研究，均强化了低密度脂蛋白胆固醇（LDL-c）在心血管疾病发生发展中的核心及因果作用。LDL-c目标值已逐渐降低，迄今为止，尚未发现存在一个LDL-c阈值，低于该阈值后降低LDL-c带来的益处就会消失。心血管风险的降低与LDL-c浓度的绝对降低成比例，无论通过何种方式实现这种降低。这些数据促使制定了新的血脂异常管理指南，尤其涉及降低LDL-c目标值以及在他汀类药物之后联合使用依折麦布和抗PCSK9抗体。
