de Jesus Mikhail, Mohammed Turab, Singh Meghana, Tiu John G, Kim Agnes S
Department of Medicine, University of Connecticut School of Medicine, Farmington, CT, United States.
Department of Medicine, Calhoun Cardiology Center, University of Connecticut School of Medicine, Farmington, CT, United States.
Front Cardiovasc Med. 2022 Apr 25;9:892335. doi: 10.3389/fcvm.2022.892335. eCollection 2022.
Patients with cancer are now living longer than ever before due to the growth and expansion of highly effective antineoplastic therapies. Many of these patients face additional health challenges, of which cardiovascular disease (CVD) is the leading contributor to morbidity and mortality. CVD and cancer share common biological mechanisms and risk factors, including lipid abnormalities. A better understanding of the relationship between lipid metabolism and cancer can reveal strategies for cancer prevention and CVD risk reduction. Several anticancer treatments adversely affect lipid levels, increasing triglycerides and/or LDL-cholesterol. The traditional CVD risk assessment tools do not include cancer-specific parameters and may underestimate the true long-term CVD risk in this patient population. Statins are the mainstay of therapy in both primary and secondary CVD prevention. The role of non-statin therapies, including ezetimibe, PCSK9 inhibitors, bempedoic acid and icosapent ethyl in the management of lipid disorders in patients with cancer remains largely unknown. A contemporary cancer patient needs a personalized comprehensive cardiovascular assessment, management of lipid abnormalities, and prevention of late CVD to achieve optimal overall outcomes.
由于高效抗肿瘤治疗方法的发展和应用,癌症患者的生存期比以往任何时候都更长。这些患者中的许多人面临着额外的健康挑战,其中心血管疾病(CVD)是发病和死亡的主要原因。CVD和癌症具有共同的生物学机制和风险因素,包括脂质异常。更好地理解脂质代谢与癌症之间的关系可以揭示癌症预防和降低CVD风险的策略。几种抗癌治疗会对脂质水平产生不利影响,增加甘油三酯和/或低密度脂蛋白胆固醇。传统的CVD风险评估工具不包括癌症特异性参数,可能会低估该患者群体真正的长期CVD风险。他汀类药物是原发性和继发性CVD预防治疗的主要药物。包括依折麦布、前蛋白转化酶枯草溶菌素9(PCSK9)抑制剂、贝派地酸和二十碳五烯酸乙酯在内的非他汀类疗法在癌症患者脂质紊乱管理中的作用仍 largely unknown。当代癌症患者需要个性化的全面心血管评估、脂质异常管理以及预防晚期CVD,以实现最佳的总体结局。 (注:“largely unknown”直译为“很大程度上未知”,这里意译为“仍不清楚”使表达更通顺些)