Khan Muhammad Shoaib, Ishaq Muhammad, Ayub Muhammad Talha, Rehman Ateeq U, Hayes John J, Mortada Mohammad, Biederman Robert W W
Department of Internal Medicine, Marshfield Clinic Health System, Marshfield, Wisconsin, USA.
Department of Cardiovascular Diseases, Rush University, Chicago, Illinois, USA.
J Lipids. 2021 Jan 12;2021:6696915. doi: 10.1155/2021/6696915. eCollection 2021.
Hypertriglyceridemia is believed to be independently associated with an elevated risk of cardiovascular disease (CVD) events. Lifestyle changes and dietary modifications are recommended for individuals with high serum triglyceride (TG) levels (150-499 mg/dl), and pharmacological therapy in addition to lifestyle modification is recommended when serum TG levels ≥ 500 mg/dl. A residual cardiovascular risk remains even in statin appropriate treated patients with CVD risk factors, and in this patient population, hypertriglyceridemia poses an independent and increased risk of ischemic events. In December 2019, the US FDA approved icosapent ethyl (IPE) as an adjunct to a maximally tolerated statin to reduce the risk of CVD events in adults with serum triglycerides > 150 mg/dl and have either established cardiovascular disease or diabetes and two or more additional CVD risk factors. Since IPE significantly decreases total ischemic events in the aforementioned patient population, it would be intriguing to know whether IPE alone added an advantage to lifestyle modification in the low-risk population, who has serum triglyceride between 150 mg/dl and 499 mg/dl.
高甘油三酯血症被认为与心血管疾病（CVD）事件风险升高独立相关。对于血清甘油三酯（TG）水平较高（150 - 499mg/dl）的个体，建议改变生活方式和调整饮食，而当血清TG水平≥500mg/dl时，除生活方式改变外还建议进行药物治疗。即使在接受他汀类药物适当治疗且有CVD危险因素的患者中，仍存在残余心血管风险，在这一患者群体中，高甘油三酯血症会带来独立且增加的缺血性事件风险。2019年12月，美国食品药品监督管理局（FDA）批准二十碳五烯酸乙酯（IPE）作为最大耐受剂量他汀类药物的辅助药物，用于降低血清甘油三酯>150mg/dl且已确诊患有心血管疾病或糖尿病以及有两个或更多其他CVD危险因素的成年人发生CVD事件的风险。由于IPE能显著降低上述患者群体中的总缺血性事件，那么了解IPE单独使用是否会给血清甘油三酯在150mg/dl至499mg/dl之间的低风险人群的生活方式改变带来优势将是很有趣的。
