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首页> 外文期刊>Current opinion in lipidology >Therapy and clinical trials: beyond low-density lipoprotein cholesterol reduction.
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Therapy and clinical trials: beyond low-density lipoprotein cholesterol reduction.

机译：治疗和临床试验：超越低密度脂蛋白胆固醇的降低。

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Coronary heart disease (CHD) morbidity and mortality are widely accepted as being associated with decreases in plasma low-density lipoprotein cholesterol (LDL-C) and current guidelines recommend statins as first-line drug therapy given the abundance of clinical endpoint data, both in primary and secondary prevention. . Though CHD risk is reduced by 22-35% in statin trials [2~(..)], a vast majority still experience CHD events despite aggressive lowering of LDL-C levels , and low high-density lipoprotein cholesterol (HDL-C) is a major risk factor in this group [2~(..)].Numerous prospective epidemiological studies have shown a strong inverse relationship between HDL-C levels and the major protein apolipoprotein A-I (apoA-I) and CHD (2-3% reduction of CHD risk for each 1 mg/dl rise in HDL-C) [2~(..)]. Different atheromatous variables [carotid intimal medial thickness (CIMT), intravascular ultrasound, atheroma burden, inflammatory markers and endothelial function] are correlated in a graded fashion to high LDL-C as has been shown with low HDL-C [4~.]. A direct comparison of the two risk factors (high LDL-C vs. low HDL-C) in the recent ARIC study suggests that the degree of CHD risk is at least similar [4~.]. Moreover, in acute coronary syndrome the short-term mortality is not dependent on LDL-C but on HDL-C (MIRACL) [4~.]. A recent meta-analysis of randomized controlled trials using HDL-C rising compounds can effectively increaseHDL-C and reduce CHD events without significant toxicity .
机译：冠心病（CHD）的发病率和死亡率被认为与血浆低密度脂蛋白胆固醇（LDL-C）降低有关，并且鉴于临床终点数据丰富，目前的指南建议将他汀类药物作为一线药物治疗一级和二级预防。 。尽管在他汀类药物试验中将冠心病的风险降低了22-35％[2〜..]，但是尽管LDL-C水平急剧降低以及高密度脂蛋白胆固醇（HDL-C）降低，绝大多数人仍会发生冠心病事件是这一组的主要危险因素[2〜（..）]。大量前瞻性流行病学研究表明，HDL-C水平与主要蛋白载脂蛋白AI（apoA-I）和冠心病（2-3％ HDL-C每升高1 mg / dl，CHD风险降低[2〜（..）]。如低HDL-C [4]所示，不同的动脉粥样硬化变量[颈动脉内膜中层厚度（CIMT），血管内超声，动脉粥样硬化负荷，炎性标志物和内皮功能]与高LDL-C呈分级相关。在最近的ARIC研究中，直接比较这两个危险因素（高LDL-C与低HDL-C）表明，冠心病的风险程度至少相似[4]。此外，在急性冠状动脉综合征中，短期死亡率不取决于LDL-C，而取决于HDL-C（MIRACL）[4]。最近使用HDL-C上升化合物进行的随机对照试验的荟萃分析可以有效增加HDL-C并减少CHD事件，而无明显毒性。

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