Department of Internal Medicine "C", Beilinson Hospital, Rabin Medical Center, Petah-Tikva, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Eur J Intern Med. 2023 Jun;112:1-5. doi: 10.1016/j.ejim.2023.02.010. Epub 2023 Feb 20.
The relative risk reduction of cardiovascular events is proportional to the absolute reduction in LDL-C levels, the primary target of therapy, no matter the way of reduction. During the last decades, the therapeutic regimens for reducing the LDL-C levels have been immerged and improved, with favorable effects on the atherosclerotic process and clinical benefits of various cardiovascular outcomes. From a practical view of point, this review is focusing only on the current available lipid lowering agents: statins, ezetimibe, anti PCSK9 monoclonal antibodies, the small interfering RNA (siRNA) agent, Inclisiran, and Bempedoic acid. The recent changes in lipid lowering regimens, including the early combination of lipid lowering agents and "Low LDL-C" levels <30 mg/dL for high/very high cardiovascular risk patients will also be discussed.
心血管事件的相对风险降低与 LDL-C 水平的绝对降低成正比，这是治疗的主要目标，无论降低的方式如何。在过去的几十年中，降低 LDL-C 水平的治疗方案不断涌现和改进，对动脉粥样硬化过程和各种心血管结局的临床益处产生了有利影响。从实际角度来看，本综述仅关注当前可用的降脂药物：他汀类药物、依折麦布、抗 PCSK9 单克隆抗体、小干扰 RNA（siRNA）药物、Inclisiran 和贝美前列素。还将讨论降脂方案的最新变化，包括降脂药物的早期联合应用以及高/极高心血管风险患者的“低 LDL-C”水平<30mg/dL。
