Department of Medicine, McGill University, and McGill University Health Centre, Montréal, Québec, Canada.
Mazankowski Alberta Heart Institute, and Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada.
Can J Cardiol. 2024 Aug;40(8S):S13-S19. doi: 10.1016/j.cjca.2024.04.023.
Atherosclerotic cardiovascular disease (ASCVD) is a significant health challenge, and apolipoprotein B (ApoB)-containing lipoproteins are increasingly recognized as central to its progression. Initially labelled as the "low-density lipoprotein hypothesis," our understanding of the etiology of ASCVD has evolved into the "ApoB principle," which highlights the causal and consistent role of all ApoB lipoproteins in ASCVD development. We review the large body of data from genetic studies, to epidemiologic studies, to clinical trials that support this foundational principle. We also provide an overview of the recommendations from guideline committees across the globe on dyslipidemia management and compare these with recent Canadian guidelines. With a few key differences, recent guidelines worldwide provide largely concordant recommendations for diagnosing and managing dyslipidemia with general consensus regarding the need for optimal control of low-density lipoprotein cholesterol and ApoB-containing lipoproteins to prevent cardiovascular events and improve patient care.
动脉粥样硬化性心血管疾病（ASCVD）是一项重大的健康挑战，载脂蛋白 B（ApoB）的脂蛋白越来越被认为是其进展的核心。最初被标记为“低密度脂蛋白假说”，我们对 ASCVD 病因的理解已经发展为“ApoB 原则”，该原则强调了所有 ApoB 脂蛋白在 ASCVD 发展中的因果和一致作用。我们回顾了大量来自遗传研究、流行病学研究和临床试验的数据，这些数据支持这一基本原理。我们还概述了全球指南委员会关于血脂异常管理的建议，并将其与最近的加拿大指南进行了比较。除了一些关键的差异，全球最近的指南在诊断和管理血脂异常方面提供了基本一致的建议，普遍认为需要优化控制低密度脂蛋白胆固醇和载脂蛋白 B 脂蛋白，以预防心血管事件并改善患者的护理。
