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Triglycerides and risk of atherosclerotic cardiovascular disease: An update.

甘油三酯与动脉粥样硬化性心血管疾病的风险: 更新。

  • 影响因子:2.06
  • DOI:10.1016/j.acvd.2020.11.006
  • 作者列表:"Farnier M","Zeller M","Masson D","Cottin Y
  • 发表时间:2021-02-01
Abstract

:Low-density lipoprotein cholesterol is a well-known causal factor for atherosclerotic cardiovascular disease, and is the primary target of lipid-lowering therapy. There is, however, still a substantial risk of atherosclerotic cardiovascular disease events despite intensive statin therapy, and data from clinical trials suggest that an elevated concentration of triglycerides is a marker of residual cardiovascular risk on low-density lipoprotein-lowering therapy. Serum triglycerides are a biomarker for triglyceride-rich lipoproteins, and several lines of evidence indicate that triglyceride-rich lipoproteins and their cholesterol-enriched remnant particles are associated with atherogenesis. Moreover, genetic data in humans strongly suggest that the remnants of triglyceride-rich lipoproteins are a causal cardiovascular risk factor. Although lifestyle changes remain the cornerstone of management of hypertriglyceridaemia, a recent trial with high doses of the omega-3 fatty acid icosapent ethyl showed a significant reduction in cardiovascular events that was not explained by the reduction in triglycerides alone. In patients with elevated triglycerides, several novel drugs are in development to reduce the residual risk on statin therapy linked to an excess of atherogenic triglyceride-rich lipoproteins. In this review, we provide an update on the biology, epidemiology and genetics of triglycerides, and the risk of atherosclerotic cardiovascular disease.

摘要

: 低密度脂蛋白胆固醇是众所周知的动脉粥样硬化性心血管疾病的致病因素,是降脂治疗的首要靶点。然而,尽管强化他汀类药物治疗,仍存在动脉粥样硬化性心血管疾病事件的显著风险,临床试验数据表明,甘油三酯浓度升高是低密度脂蛋白降低治疗的残余心血管风险的标志物。血清甘油三酯是富含甘油三酯的脂蛋白的生物标志物,并且几行证据表明富含甘油三酯的脂蛋白及其富含胆固醇的残余颗粒与动脉粥样硬化有关。此外,人类的遗传数据强烈表明,富含甘油三酯的脂蛋白的残余物是心血管危险因素。尽管生活方式的改变仍然是治疗高甘油三酯血症的基石,但最近一项使用高剂量omega -3脂肪酸二十碳四烯酸乙酯的试验显示,心血管事件显著减少,这并不能单独用甘油三酯的减少来解释.在甘油三酯升高的患者中,几种新型药物正在开发中,以降低他汀类药物治疗的残余风险,这些风险与致动脉粥样硬化的富含甘油三酯的脂蛋白过量有关。在这篇综述中,我们提供了关于甘油三酯的生物学流行病学和遗传学以及动脉粥样硬化性心血管疾病风险的最新进展。

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DOI:10.1007/s11033-021-06299-9
作者列表:["Louvrier A","Terranova L","Meyer C","Meyer F","Euvrard E","Kroemer M","Rolin G"]

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