动脉粥样硬化性心血管疾病预防 - The Left Main and Coronary Artery Bifurcation Lesion Summit (CBS)

文章摘要

Lipid-Modifying Agents, From Statins to PCSK9 Inhibitors: JACC Focus Seminar
From Subclinical Atherosclerosis to Plaque Progression and Acute Coronary Events
Coronary calcification in the diagnosis of coronary artery disease
Stage-dependent differential effects of interleukin-1 isoforms on experimental atherosclerosis
High-risk plaque detected on coronary CT angiography predicts acute coronary syndromes independent of significant stenosis in acute chest pain: results from the ROMICAT-II trial
Short-Term Progression of Multiterritorial Subclinical Atherosclerosis
Association of Circulating Monocyte Chemoattractant Protein-1 Levels With Cardiovascular Mortality: A Meta-analysis of Population-Based Studies
From Focal Lipid Storage to Systemic Inflammation
Negative Risk Markers for Cardiovascular Events in the Elderly
Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy

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Review Article

Volume 75, Issue 16, April 2020

JOURNAL：JACC

Article Link

Lipid-Modifying Agents, From Statins to PCSK9 Inhibitors: JACC Focus Seminar

D Preiss, JA Tobert, GK Hovingh et al.

5820

Keywords: ezetimibe; low-density lipoprotein cholesterol; Mendelian randomization; proprotein convertase subtilisin/kexin type 9; statin

ABSTRACT

Mendelian randomization studies and randomized trials have conclusively demonstrated that lower low-density lipoprotein (LDL) cholesterol results in fewer cardiovascular events. This review describes key stages in the evolution of LDL cholesterol–lowering treatment. Data from over 25 cardiovascular outcome trials confirm that, within a few years, statins lower the relative risk of major atherosclerotic events by about 22% per 38.7 mg/dl (1 mmol/l) reduction in LDL cholesterol, with similar benefit across patient subgroups. Meta-analyses of these trials have established the safety of statins with regard to nonvascular mortality and cancer. Other agents available for prescription include ezetimibe and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, which both reduce major atherosclerotic events in proportion to their effects on LDL cholesterol and have good safety profiles, though PCSK9 inhibitors remain costly. Investigational LDL cholesterol–lowering agents currently being tested in cardiovascular outcome studies are bempedoic acid, an adenosine triphosphate–citrate lyase inhibitor that reduces cholesterol synthesis, and inclisiran, a double-stranded small interfering ribonucleic acid that inhibits PCSK9 synthesis.