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首页> 外文期刊>Clinical cardiology. >Rounding the corner on residual risk: Implications of REDUCE‐IT for omega‐3 polyunsaturated fatty acids treatment in secondary prevention of atherosclerotic cardiovascular disease
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Rounding the corner on residual risk: Implications of REDUCE‐IT for omega‐3 polyunsaturated fatty acids treatment in secondary prevention of atherosclerotic cardiovascular disease

机译：消除残留风险的转折点：REDUCE-IT对Omega-3多不饱和脂肪酸治疗在动脉粥样硬化性心血管疾病的二级预防中的意义

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Patients with established atherosclerotic cardiovascular (CV) disease remain at increased risk of major adverse cardiovascular events even during optimal lipid‐lowering therapy. Recent studies using the methods of Mendelian randomization, as well as analyses of data from large statin trials, have concluded that elevated triglyceride (TG) levels contribute to that increased risk. Omega‐3 polyunsaturated fatty acids (omega‐3 PUFAs) from fish and shellfish (eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) reduce TG levels when added to the diet in sufficient amounts, and they have favorable effects on several other markers of CV risk. However, trials of omega‐3 PUFAs have had inconsistent findings regarding CV risk reduction. Recently, the REDUCE‐IT (Reduction of Cardiovascular Events with EPA‐Intervention Trial) trial reported that treatment of such high‐risk patients with icosapent ethyl, a purified and stabilized ethyl ester of EPA, reduced the risk of the trial's primary CV endpoint by 25% (95% confidence intervals [CI], 32%‐17%; P ?.001). To appreciate the clinical implications of this result, it is important to understand how the REDUCE‐IT trial differed from previous trials, especially with regard to patient enrollment criteria and treatment dosing. We discuss these design features relative to other trials. TG lowering can account for only part of the risk reduction seen with icosapent ethyl; we also consider other potential contributory mechanisms.
机译：即使在最佳的降脂治疗期间，已建立动脉粥样硬化性心血管（CV）疾病的患者仍然存在发生重大不良心血管事件的风险。最近使用孟德尔随机方法进行的研究以及对大型他汀类药物试验数据的分析得出的结论是，甘油三酯（TG）水平升高会导致风险增加。鱼类和贝类中的欧米伽3多不饱和脂肪酸（欧米伽3 PUFA）（二十碳五烯酸[EPA]和二十二碳六烯酸[DHA]）当添加到饮食中时会降低TG的含量，并且它们对其他几个指标也具有良好的作用简历风险。但是，对于降低CV风险，omega-3 PUFA的试验结果不一致。最近，REDUCE-IT（通过EPA干预试验减少心血管事件）试验报告说，用高纯度的稳定的EPA乙酯二十碳五烯酸乙酯治疗此类高危患者，可通过以下方法降低该试验的主要心血管终点风险25％（95％置信区间[CI]，32％-17％; P

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