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胆固醇和他汀类药物与急性冠脉综合征的关系:综述

摘要

简介:动脉粥样硬化是冠状动脉疾病(CAD)和急性冠脉综合征(ACS)发生的主要危险因素之一。脂质对这些疾病的贡献证明了世界上有2亿人在服用他汀类药物。然而，科学研究表明，尽管他汀类药物可以有效降低胆固醇水平，但这种降低与心血管疾病(CVD)相关的发病率和死亡率降低之间的关系一直受到质疑。这篇综述的目的是找到已经发表的内容，以尝试回答两个问题:1.在研究中，我们需要研究。胆固醇是ACS发生的主要危险因素吗?2.他汀类药物对降低ACS的发病率和死亡率有显著影响吗?方法:在PubMed和谷歌学者数据库中对2014年至2018年的相关英语科学文章进行书目检索。结果:他汀类药物作为降脂药物的疗效毋庸置疑，但其对ACS发病率和死亡率的影响尚不明确。批评出现在JUPITER、AFCAPS/TEXCAPS、PROVE-IT-TIMI-22和TNT研究等调查中，其中一些研究由制药行业赞助。 New theories on the pathogenesis of ACS have been delineated as the contribution of inflammatory mechanisms in the process of atherogenesis. Discussion: Cost-effectiveness, statin effectiveness, and other investigations of ACS contributors should be considered, such as inflammation and insulin resistance theory. Statins also have an anti-inflammatory effect (pleiotropic effect) and therefore studies are being conducted to determine whether the reduction of inflammation will be as effective in reducing adverse CV events regardless of statinsproven hypolipidaemia. Furthermore, insulin resistance may play a major role in this atherogenic inflammatory process. Conclusion: A complete and combined treatment is required not only for dyslipidemia but also for insulin resistance, never forgetting the changes in the dietary pattern.

Humberto SM和Mariana SB

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