Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD, USA.
Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD, USA; Community Hospital General Medical Center, Sterling, IL, USA.
Trends Cardiovasc Med. 2022 May;32(4):181-194. doi: 10.1016/j.tcm.2021.04.002. Epub 2021 Apr 17.
Coronary heart disease (CHD) is the leading cause of morbidity and mortality world-wide and has been characterized as a chronic immunoinflammatory, fibroproliferative disease fueled by lipids. Great advances have been made in elucidating the complex mechanistic interactions among risk factors associated with CHD, yielding abundant success towards preventive measures and the development of pharmaceuticals to prevent and treat CHD via attenuation of lipoprotein-mediated risk. However, significant residual risk remains. Several potentially modifiable CHD risk factors ostensibly contributing to this residual risk have since come to the fore, including systemic inflammation, diabetes mellitus, high-density lipoprotein, plasma triglycerides (TG) and remnant lipoproteins (RLP), lipoprotein(a) (Lp[a]), and vascular endothelial dysfunction (ED). Herein, we summarize the body of evidence implicating each of these risk factors in residual CHD risk.
冠心病(CHD)是全球发病率和死亡率的主要原因,其特征为慢性免疫炎症、纤维增生性疾病,由脂质引发。在阐明与 CHD 相关的危险因素之间复杂的机制相互作用方面取得了巨大进展,通过减轻脂蛋白介导的风险,为预防措施和开发预防和治疗 CHD 的药物带来了丰富的成功。然而,仍然存在显著的剩余风险。一些潜在可改变的 CHD 危险因素显然促成了这种剩余风险,包括全身炎症、糖尿病、高密度脂蛋白、血浆甘油三酯(TG)和残余脂蛋白(RLP)、脂蛋白(a)(Lp[a])和血管内皮功能障碍(ED)。在此,我们总结了这些危险因素中每一个在残余 CHD 风险中的作用的证据。
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