Department of Medicine, Baylor College of Medicine, Houston, Texas 77030, USA; email:
Annu Rev Med. 2021 Jan 27;72:431-446. doi: 10.1146/annurev-med-100119-013612. Epub 2020 Nov 20.
Although numerous trials have convincingly shown benefits of statin therapy in both primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD), most showed relative risk reductions of 25-40%, and thus many individuals continue to have ASCVD events despite statin therapy. Substantial progress has been made in developing therapies that address the residual risk for ASCVD despite statin therapy. In this review, we summarize progress of currently available therapies along with therapies under development that further reduce low-density lipoprotein cholesterol and apolipoprotein B-containing lipoproteins, reduce lipoprotein(a), reduce ASCVD events in patients with high triglycerides, and directly target inflammation to reduce ASCVD risk.
尽管许多临床试验令人信服地表明他汀类药物治疗在动脉粥样硬化性心血管疾病(ASCVD)的一级和二级预防中均有益处,但大多数试验显示相对风险降低了 25-40%,因此尽管进行了他汀类药物治疗,许多患者仍会发生 ASCVD 事件。尽管进行了他汀类药物治疗,但在开发针对 ASCVD 剩余风险的治疗方法方面已取得重大进展。在这篇综述中,我们总结了目前可用的治疗方法以及正在开发的治疗方法的进展,这些方法可进一步降低低密度脂蛋白胆固醇和载脂蛋白 B 脂蛋白,降低脂蛋白(a),降低高甘油三酯患者的 ASCVD 事件,并直接靶向炎症以降低 ASCVD 风险。