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动脉粥样硬化性心血管疾病的二级预防策略

Strategies for the Secondary Prevention of Atherosclerotic Cardiovascular Disease.

作者信息

Hurwitz Madelyn, Agboola Olayinka J, Gami Abhishek, Williams Marlene S, Virani Salim S, Sharma Garima V, Patel Jaideep

机构信息

School of Medicine, University of Virginia Charlottesville, VA.

Department of Cardiology, Inova Schar Heart and Vascular Institute Falls Church, VA.

出版信息

US Cardiol. 2025 Apr 28;19:e11. doi: 10.15420/usc.2024.33. eCollection 2025.

Abstract

Patients with atherosclerotic cardiovascular disease (ASCVD), such as those with a history of MI or stroke, are at high risk for morbidity and mortality associated with future cardiovascular events. Ideal management of these patients requires a multifactorial strategy for risk factor mitigation and prevention of additional cardiovascular events. Traditional management of secondary prevention patients involves lipid-lowering with statins, blood pressure control, and anti-platelet treatment. Several additional targets have been identified to optimize the secondary prevention of ASCVD, such as further lipid control, inflammation management, lifestyle and weight optimization, strict diabetes control, use of β-blockers, use of renin-angiotensin-aldosterone system inhibitors, vaccinations, and additional considerations of anti-thrombotic therapies. This review will describe the interventions associated with these targets, as well as the relevant research and indications for these therapies.

摘要

患有动脉粥样硬化性心血管疾病(ASCVD)的患者,如那些有心肌梗死或中风病史的患者,面临着与未来心血管事件相关的高发病率和死亡率风险。对这些患者进行理想的管理需要采取多因素策略来减轻危险因素并预防额外的心血管事件。二级预防患者的传统管理包括使用他汀类药物降低血脂、控制血压和抗血小板治疗。已经确定了几个额外的目标来优化ASCVD的二级预防,如进一步控制血脂、管理炎症、优化生活方式和体重、严格控制糖尿病、使用β受体阻滞剂、使用肾素-血管紧张素-醛固酮系统抑制剂、接种疫苗以及对抗血栓治疗的其他考虑因素。本综述将描述与这些目标相关的干预措施,以及这些治疗方法的相关研究和适应症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98ab/12060178/35e0440ec9ab/usc-19-e11-g001.jpg

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