VMMC and Safdarjung Hospital, New Delhi, India.
VMMC and Safdarjung Hospital, New Delhi, India.
Indian Heart J. 2021 Mar-Apr;73(2):249-252. doi: 10.1016/j.ihj.2021.01.017. Epub 2021 Jan 16.
The exploratory analysis of FOURIER trial has offered a ray of hope for patients with nonrheumatic aortic stenosis (AS). At present, the only definitive treatment of severe AS is aortic valve replacement (AVR). Despite transaortic valvular replacement revolutionizing the treatment of AS, it still remains a progressive condition, with no disease-modifying pharmacotherapy. Angiotensin-converting-enzyme inhibitors, angiotensin receptor blockers, eplerenone, nitrates and statins all have been tried previously but failed to slow down the progression of aortic stenosis. Recently, there has been an emerging role of lipoprotein A [Lp(a)] in the pathogenesis of AS. This raises the possibility that long-term therapy with specific emphasis on Lp(a) reduction may reduce or slow the progression of AS.
FOURIER 试验的探索性分析为非风湿性主动脉瓣狭窄(AS)患者带来了一线希望。目前,严重 AS 的唯一确定性治疗方法是主动脉瓣置换术(AVR)。尽管经主动脉瓣置换术彻底改变了 AS 的治疗方法,但它仍然是一种进行性疾病,没有疾病修饰的药物治疗。血管紧张素转换酶抑制剂、血管紧张素受体阻滞剂、依普利酮、硝酸盐和他汀类药物以前都曾尝试过,但未能减缓主动脉瓣狭窄的进展。最近,脂蛋白 A [Lp(a)] 在 AS 的发病机制中的作用引起了关注。这就提出了一种可能性,即长期的、特别强调降低 Lp(a)的治疗可能会减少或减缓 AS 的进展。
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