Abstract
During the last decade, the evidence of beneficial effects of cholesterol lowering in patients with coronary heart disease has been proven in many clinical trials. The National Cholesterol Education Program (NCEP) released 2004 update to the Adult Treatment Panel III (ATP III) guidelines. The new guidelines of European Society of Cardiology announced in 2007 support more intensive LDL-C lowering in patients at high risk of cardiovascular diseases. For patients at the highest risk of cardiovascular diseases (diabetic patients with coronary heart disease), the recommended LDL-C goal is <1.8 mmol/L. In very high-, high-, and moderately high-risk patients, statin therapy should be considered with a treatment targeting an LDL-C reduction of 30-40%. Clinical studies have shown that statin therapy alone is not always effective, especially in patients with primary hypercholesterolemia. Furthermore, high doses of statins can increase the possibility of adverse events. The combination of statins with intestinal cholesterol absorption inhibitors is more effective than statin monotherapy in LDL-C lowering and is well tolerated.
Highlights
The evidence of beneficial effects of cholesterol lowering in patients with coronary heart disease has been proven in many clinical trials
The new guidelines of European Society of Cardiology announced in 2007 support more intensive LDL-C lowering in patients at high risk of cardiovascular diseases
In very high, high, and moderately high-risk patients, statin therapy should be considered with a treatment targeting an LDL-C reduction of 30– 40%
Summary
Pastaraisiais metais pasibaigę klinikiniai tyrimai įtikinamai įrodė, kad agresyvus gydymas statinais, sumažinus MTL-C koncentraciją kraujyje mažiau nei 1,8 mmol/l (70 mg/dl), žymiai sumažino kardiovaskulinių įvykių dažnį. Treating to New Targets), kuriame dalyvavo 10001 ligonis, sergantis stabiliąja krūtinės angina, nustatė, kad intensyvus lipidų mažinimas, gydant 80 mg atorvastatinu per parą, sumažino MTL-C koncentraciją (vidutiniškai iki 2,0 mmol/l) ir didžiųjų išeminių įvykių dažnį (2,2 proc.) bei santykinę riziką (22 proc.) palyginus su gydymu atorvastatinu 10 mg per parą, tačiau bendrasis mirštamumas nesiskyrė [13]. Tačiau pastaraisiais metais pasibaigę klinikiniai tyrimai (ASCOT, REVERSAL, ARBITER, HPS, PROVE IT) įtikinamai įrodė, kad agresyvus gydymas statinais, sumažinus MTL-C koncentraciją kraujyje mažiau nei 1,8 mmol/l, žymiai sumažino išeminių sutrikimų dažnį. NCEP ATP III rekomenduojamos mažo tankio lipoproteinų cholesterolio (MTL-C) koncentracijos priklausomai nuo ligonių rizikos grupės (remiantis 6, 14)
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
