Safarova Maya S, Weintraub Spencer, Sadaniantz Katherine, Kovell Lara, Warden Bruce A, Garshick Michael S, Duell P Barton, Gianos Eugenia
Department of Medicine, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
Northwell Cardiovascular Institute, North Shore University Hospital, Manhasset, NY, USA.
Curr Atheroscler Rep. 2025 May 1;27(1):54. doi: 10.1007/s11883-025-01298-8.
Outcome benefits for HMG-CoA reductase inhibitor (statin) use in the prevention of atherosclerotic cardiovascular disease (ASCVD) are well established and yet, statins remain underutilized with only half of eligible individuals receiving them among certain vulnerable populations. This review critically examines available data to provide a summary of the current evidence for statin use in select populations.
Lipid management can be more complex in patients with chronic kidney disease (CKD), organ transplants, metabolic dysfunction associated with steatotic liver disease (MASLD), and human immunodeficiency virus (HIV). Statins are generally safe and effective to reduce the burden of ASCVD among these highly heterogeneous groups of patients and should be considered with careful attention to their concomitant disease state. Herein, we focus on appropriate statin use in these challenging to treat conditions, their relationship with increased ASCVD risk, and approaches to statin use for ASCVD risk reduction. Although further research is needed to define optimal therapy in select high risk groups for ASCVD prevention, statins are proven to be clinically efficacious, safe, and cost-effective for ASCVD prevention, warranting greater efforts to increase their use.
HMG-CoA还原酶抑制剂（他汀类药物）用于预防动脉粥样硬化性心血管疾病（ASCVD）的疗效已得到充分证实，但他汀类药物的使用仍未得到充分利用，在某些弱势群体中，只有一半符合条件的个体接受了此类药物治疗。本综述严格审查现有数据，以总结他汀类药物在特定人群中使用的当前证据。
在慢性肾脏病（CKD）、器官移植、与脂肪性肝病相关的代谢功能障碍（MASLD）和人类免疫缺陷病毒（HIV）患者中，血脂管理可能更为复杂。他汀类药物通常安全有效，可减轻这些高度异质性患者群体中ASCVD的负担，应在充分考虑其伴随疾病状态的情况下予以考虑。在此，我们重点关注他汀类药物在这些难以治疗的疾病中的合理使用、它们与ASCVD风险增加的关系，以及使用他汀类药物降低ASCVD风险的方法。尽管需要进一步研究来确定ASCVD预防特定高危人群的最佳治疗方案，但他汀类药物已被证明对ASCVD预防具有临床疗效、安全性和成本效益，因此有必要加大力度提高其使用率。
