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New Strategies for Lowering Low Density Lipoprotein Cholesterol for Cardiovascular Disease Prevention. 降低低密度脂蛋白胆固醇预防心血管疾病的新策略。
IF 2 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-09-01 Epub Date: 2022-06-25 DOI: 10.1007/s12170-022-00694-y
Sean Paul Gaine, Renato Quispe, Jaideep Patel, Erin D Michos

Purpose of review: The primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD) relies on optimizing cardiovascular health and appropriate pharmacotherapy, a mainstay of which is low-density lipoprotein-cholesterol (LDL-C) lowering. Typically, statin therapy remains the first line approach. Advances in technology and understanding of lipid metabolism have facilitated the development of several novel therapeutic targets and medications within the last decade. This review focuses on medications recently approved by the U.S. Food and Drug Administration (FDA) for the reduction of LDL-C and ASCVD risk, as well as new therapies in the pipeline.

Recent findings: Novel lipid therapies aim to lower risk of ASCVD by targeting reduction of atherogenic compounds, such as LDL, lipoprotein(a) (Lp(a)), and triglyceride-rich lipoproteins. Evolocumab and alirocumab, monoclonal antibody proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors which lower LDL-C by approximately 60%, have emerged as important therapies for use in patients with ASCVD as well as familial hypercholesterolemia (FH). Bempedoic acid, an ATP citrate lyase inhibitor, is an oral medication recently approved that can lower LDL-C by approximately 18% alone and 38% when combined with ezetimibe. Inclisiran, a small-interfering RNA (siRNA) molecule which inhibits the translation of PCSK9, is the most recently FDA-approved LDL-C lowering medication, and can reduce LDL-C by approximately 50% with twice yearly subcutaneous dosing. The cardiovascular outcome trials for bempedoic acid and inclisiran are still on-going. Evinacumab, a monoclonal antibody which targets angiopoietin-like protein 3 (ANGPTL3), has been approved for use in patients with homozygous FH. SiRNAs and anti-sense oligonucleotides (ASO) facilitating selective inhibition of the production of targeted proteins including Lp(a) and ANGLPTL3 are active areas of clinical investigation.

Summary: Recently several novel LDL-C lowering medications have been approved. New therapeutic targets have been identified and present additional means of lowering LDL-C and other atherogenic compounds for patients who remain at high ASCVD risk.

综述的目的:动脉粥样硬化性心血管疾病(ASCVD)的一级和二级预防依赖于优化心血管健康和适当的药物治疗,其中主要是降低低密度脂蛋白胆固醇(LDL-C)。通常,他汀类药物治疗仍是一线治疗方法。过去十年中,技术的进步和对脂质代谢的了解促进了多种新型治疗靶点和药物的开发。本综述重点介绍美国食品药品管理局(FDA)最近批准的用于降低低密度脂蛋白胆固醇(LDL-C)和ASCVD风险的药物,以及正在研发中的新疗法:新型血脂疗法旨在通过减少致动脉粥样硬化化合物,如低密度脂蛋白、脂蛋白(a)(Lp(a))和富含甘油三酯的脂蛋白,来降低ASCVD风险。Evolocumab 和 alirocumab 是单克隆抗体丙蛋白转换酶-枯草酶-kexin 9 型(PCSK9)抑制剂,可将低密度脂蛋白胆固醇降低约 60%,已成为用于 ASCVD 和家族性高胆固醇血症(FH)患者的重要疗法。本贝多酸是一种 ATP 枸橼酸裂解酶抑制剂,是最近获批的一种口服药物,单独使用时可将低密度脂蛋白胆固醇降低约 18%,与依折麦布联合使用时可降低 38%。Inclisiran 是一种抑制 PCSK9 翻译的小干扰 RNA(siRNA)分子,是最近获得 FDA 批准的降低低密度脂蛋白胆固醇的药物,每年两次皮下注射可使低密度脂蛋白胆固醇降低约 50%。bempedoic acid 和 inclisiran 的心血管效果试验仍在进行中。Evinacumab 是一种针对血管生成素样蛋白 3 (ANGPTL3) 的单克隆抗体,已被批准用于治疗同基因 FH 患者。SiRNA和反义寡核苷酸(ASO)有助于选择性抑制包括脂蛋白(a)和ANGLPTL3在内的靶蛋白的产生,是目前临床研究的热点领域:最近,几种新型降低低密度脂蛋白胆固醇药物获得批准。新的治疗靶点已经确定,这为仍有高 ASCVD 风险的患者提供了降低 LDL-C 和其他致动脉粥样硬化化合物的新方法。
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引用次数: 0
Coronary Artery Calcium-Based Approach to Lipid Management 基于钙的冠状动脉脂质管理方法
IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-08-19 DOI: 10.1007/s12170-022-00704-z
Ayeeshik Kole, P. Joshi
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引用次数: 0
Triglyceride-Rich Lipoproteins, Remnants, and Atherosclerotic Cardiovascular Disease Risk 富含甘油三酯的脂蛋白、残留物与动脉粥样硬化性心血管疾病风险
IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-07-23 DOI: 10.1007/s12170-022-00702-1
V. Bharadiya, Swasti Rawal, V. Jain, P. Chevli, Anurag Mehta
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引用次数: 0
Cardiovascular Health of Black Women Before, During, and After Pregnancy: A Call to Action and Implications for Prevention 黑人妇女怀孕前、怀孕期间和怀孕后的心血管健康:对行动的呼吁和预防的影响
IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-07-23 DOI: 10.1007/s12170-022-00703-0
R. Bond, Kameelah Phillips, Kendra N. Ivy, Vanessa Ogueri, B. Parapid, S. C. Miller, Annette K. Ansong
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引用次数: 1
Racial and Ethnic Disparities in Cardiovascular Disease Risk Among Patients with Chronic Kidney Disease 慢性肾脏病患者心血管疾病风险的种族和民族差异
IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-07-23 DOI: 10.1007/s12170-022-00701-2
D. Adedinsewo, Ivan E. Porter, R. White, L. Hickson
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引用次数: 1
Sex Differences in Cardiomyopathy 心肌病的性别差异
IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-07-22 DOI: 10.1007/s12170-022-00700-3
Chris Taylor, Emily S. Lau
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引用次数: 0
Using Atrial Fibrillation Symptoms to Guide Treatment: Becoming PROs at Improving Quality of Life 利用房颤症状指导治疗:成为提高生活质量的专家
IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-07-22 DOI: 10.1007/s12170-022-00695-x
B. Zenger, B. Steinberg
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引用次数: 0
Arrhythmia-Induced Cardiomyopathy: Mechanisms and Risk Assessment to Guide Management and Follow-Up 心律失常引起的心肌病:机制和风险评估指导管理和随访
IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-07-18 DOI: 10.1007/s12170-022-00699-7
Luke Chong, R. Gopinathannair, Ali Ahmad, Philip L. Mar, B. Olshansky
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引用次数: 0
Lipoprotein(a)—When to Screen and How to Treat 脂蛋白(a) -何时筛查及如何治疗
IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-07-11 DOI: 10.1007/s12170-022-00698-8
N. Patel, N. Mittal, P. Choubdar, P. Taub
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引用次数: 0
Risk factors and Management of Mitral Annular Atrial Flutter After Mitral Valve Surgery 二尖瓣手术后二尖瓣环心房扑动的危险因素及处理
IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-07-08 DOI: 10.1007/s12170-022-00696-w
A. Sriramoju, Mostafa Elbanna, K. Cheema, Nway Le Ko Ko, Komandoor Srivathsan
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引用次数: 0
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Current Cardiovascular Risk Reports
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