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意大利经皮冠状动脉介入治疗的冠心病患者的降脂治疗:意大利心脏病学会介入心脏病学工作组的专家意见文件。

Lipid-lowering therapy in patients with coronary artery disease undergoing percutaneous coronary interventions in Italy: an expert opinion paper of Interventional Cardiology Working Group of Italian Society of Cardiology.

机构信息

Department of Translational Medical Sciences, University of Campania 'Luigi Vanvitelli', Naples.

Division of Cardiology, A.O.R.N. 'Sant'Anna e San Sebastiano', Caserta.

出版信息

J Cardiovasc Med (Hagerstown). 2023 Apr 1;24(Suppl 1):e86-e94. doi: 10.2459/JCM.0000000000001440.

Abstract

After percutaneous coronary interventions (PCIs), patients remain at high risk of developing recurrent cardiovascular events. Despite advances in interventional cardiology, the correct management of residual low-density lipoprotein cholesterol (LDL-C) risk continues to be crucial for improving long-term outcomes after PCI. However, several observational studies have demonstrated suboptimal LDL-C control, poor adherence to statin therapy, and underutilization of high-intensity statins, ezetimibe, and proprotein convertase subtilisin/kexin type 9 inhibitors in real-world clinical practice despite a strong endorsement from international guidelines. Recent studies have shown that early intensive lipid-lowering therapy stabilizes atheromatous plaque and increases fibrous cap thickness in patients with acute coronary syndrome. This finding emphasizes the importance of achieving therapeutic targets by establishing an effective treatment as early as possible. The aim of this expert opinion paper of the Interventional Cardiology Working Group of the Italian Society of Cardiology is to discuss the management of lipid-lowering therapy in patients undergoing PCIs according to Italian reimbursement policies and regulations, with a particular focus on the discharge phase.

摘要

经皮冠状动脉介入治疗(PCI)后,患者仍存在发生心血管事件复发的高风险。尽管介入心脏病学取得了进步,但正确管理残余低密度脂蛋白胆固醇(LDL-C)风险对于改善 PCI 后的长期预后仍然至关重要。然而,尽管国际指南强烈推荐,但几项观察性研究表明,在真实世界的临床实践中,LDL-C 控制不佳、他汀类药物治疗的依从性差以及高强度他汀类药物、依折麦布和前蛋白转化酶枯草溶菌素 9 抑制剂的使用率低。最近的研究表明,早期强化降脂治疗可稳定急性冠状动脉综合征患者的动脉粥样硬化斑块并增加纤维帽厚度。这一发现强调了通过尽早建立有效的治疗来达到治疗目标的重要性。意大利心脏病学会介入心脏病学工作组这份专家意见文件的目的是根据意大利的报销政策和规定,讨论接受 PCI 的患者的降脂治疗管理,特别关注出院阶段。

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