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首页> 外文期刊>Current opinion in lipidology >Therapy and clinical trials.
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Therapy and clinical trials.

机译：治疗和临床试验。

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Extensive clinical trial data have shown that statin-mediated low-density lipoprotein (LDL) cholesterol reductions are associated with significant improvements in cardiovascular disease (CVD) outcomes. Such findings are reflected in current CVD management guidelines that focus on the plasma LDL-cholesterol level as the primary therapeutic target. The National Cholesterol Education Program's 2004 report recommended more aggressive optional LDL-cholesterol treatment goals of less than 70 mg/dl (1.81 mmol/l) for secondary prevention in cardiovascular patients. Hayward et al. reviewed the clinical evidence for and against the recommended treatment goals for LDL-cholesterol levels in cardiovascular patients. Although they did not find any high quality evidence to support the currently proposed treatment goals for LDL-cholesterol, the authors still recommend that most patients at high risk of CVD should be taking at least a moderate dose of a statin even if their natural plasma LDL-cholesterol level is low.Hong et al. evaluated the beneficial effects of statin therapy on the regression of coronary plaque size in 103 patients using a serial intravascular ultrasound method. The authors found that the only independent predictor of changes in coronary plaque size was the follow-up LDL-cholesterol level. The LDL-cholesterol level should be less than 100 mg/dl in order to achieve regression or no progression of coronary plaque. Kopecky reviewed the use of beta-blockers on reducing the risk of events after acute myocardial infarction (AMI). The beta-blocker, carvedilol, has several additional pharmacological properties such as alpha1-blocking, antioxidant, anti-inflammatory and anti-arrhythmic activities. These properties of carvedilol make a strong case for its preferential use in post-AMI patients. Randomized, placebo-controlled double-blinded studies are required in order to recommend its preferential use in AMI patients.
机译：大量的临床试验数据表明，他汀类药物介导的低密度脂蛋白（LDL）胆固醇的降低与心血管疾病（CVD）结果的显着改善有关。这些发现反映在当前的CVD管理指南中，该指南将血浆LDL-胆固醇水平作为主要治疗目标。美国国家胆固醇教育计划（National Cholesterol Education Program，2004）的报告建议对心血管患者进行二级预防时，将更具积极性的可选LDL-胆固醇治疗目标设为低于70 mg / dl（1.81 mmol / l）。海沃德等。回顾了支持和反对心血管患者LDL-胆固醇水平推荐治疗目标的临床证据。尽管他们没有找到任何高质量的证据来支持目前提议的LDL-胆固醇治疗目标，但作者仍建议大多数具有CVD高风险的患者至少应服用中等剂量的他汀类药物，即使他们的天然血浆LDL -胆固醇水平低。评估了他汀类药物治疗对103例患者的一系列血管内超声方法对冠状动脉斑块大小消退的有益作用。作者发现，冠状动脉斑块大小变化的唯一独立预测因素是随访的LDL-胆固醇水平。 LDL-胆固醇水平应低于100 mg / dl，以使冠状动脉斑块消退或无进展。 Kopecky回顾了使用β受体阻滞剂降低急性心肌梗死（AMI）后发生事件的风险。 β-受体阻滞剂卡维地洛具有多种其他药理特性，例如α1阻滞，抗氧化剂，抗炎和抗心律不齐活性。卡维地洛的这些特性为其在AMI后患者中的优先使用提供了强有力的证据。需要进行随机，安慰剂对照的双盲研究，以推荐其在AMI患者中的优先使用。

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