Residual macrovascular risk in 2013: what have we learned?
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- 作者：Jean-Charles Fruchart (1) (2)
Jean Davignon (3)
Michel P Hermans (4)
Khalid Al-Rubeaan (5)
Pierre Amarenco (6)
Gerd Assmann (7)
Philip Barter (8)
John Betteridge (9)
Eric Bruckert (10)
Ada Cuevas (11)
Michel Farnier (12)
Ele Ferrannini (13)
Paola Fioretto (14)
Jacques Genest (15)
Henry N Ginsberg (16)
Antonio M Gotto Jr (17)
Dayi Hu (18)
Takashi Kadowaki (19)
Tatsuhiko Kodama (20)
Michel Krempf (21)
Yuji Matsuzawa (22)
Jesús Millán Nú?ez-Cortés (23)
Carlos Calvo Monfil (24)
Hisao Ogawa (25)
Jorge Plutzky (26)
Daniel J Rader (27)
Shaukat Sadikot (28)
Raul D Santos (29)
Evgeny Shlyakhto (30)
Piyamitr Sritara (31)
Rody Sy (32)
Alan Tall (33)
Chee Eng Tan (34)
Lale Tokg?zo?lu (35)
Peter P Toth (36)
Paul Valensi (37)
Christoph Wanner (38)
Alberto Zambon (14)
Junren Zhu (39)
Paul Zimmet (40) - 关键词：Residual cardiovascular risk ; Atherogenic dyslipidaemia ; Type 2 diabetes ; Therapeutic options
- 刊名：Cardiovascular Diabetology
- 出版年：2014
- 出版时间：December 2014
- 年：2014
- 卷：13
- 期：1
- 全文大小：507 KB
- 作者单位：Jean-Charles Fruchart (1) (2)
Jean Davignon (3)
Michel P Hermans (4)
Khalid Al-Rubeaan (5)
Pierre Amarenco (6)
Gerd Assmann (7)
Philip Barter (8)
John Betteridge (9)
Eric Bruckert (10)
Ada Cuevas (11)
Michel Farnier (12)
Ele Ferrannini (13)
Paola Fioretto (14)
Jacques Genest (15)
Henry N Ginsberg (16)
Antonio M Gotto Jr (17)
Dayi Hu (18)
Takashi Kadowaki (19)
Tatsuhiko Kodama (20)
Michel Krempf (21)
Yuji Matsuzawa (22)
Jesús Millán Nú?ez-Cortés (23)
Carlos Calvo Monfil (24)
Hisao Ogawa (25)
Jorge Plutzky (26)
Daniel J Rader (27)
Shaukat Sadikot (28)
Raul D Santos (29)
Evgeny Shlyakhto (30)
Piyamitr Sritara (31)
Rody Sy (32)
Alan Tall (33)
Chee Eng Tan (34)
Lale Tokg?zo?lu (35)
Peter P Toth (36)
Paul Valensi (37)
Christoph Wanner (38)
Alberto Zambon (14)
Junren Zhu (39)
Paul Zimmet (40)
1. R3i Foundation, St, Alban-Anlage 46, Basel, CH, 4010, Switzerland
2. Fondation C?ur et Artères, Lille, France
3. Institut de recherches cliniques de Montréal; Centre Hospitalier de l’Université de Montréal and Department of Experimental Medicine, McGill University, Montreal, Canada
4. Cliniques Universitaires Saint-Luc, Brussels, Belgium
5. University Diabetes Center, King Saud University, Riyadh, Saudi Arabia
6. Department of Neurology and Stroke Centre, Bichat University Hospital, Paris, France
7. Assmann-Stiftung für Pr?vention, Münster, Germany
8. Centre for Vascular Research, University of New South Wales, Sydney, Australia
9. University College London, London, UK
10. Department of Endocrinology and Cardiovascular Disease Prevention, Institut of CardioMetabolism and Nutrition (ICAN) H?pital Pitié-Salpêtrière, Paris, France
11. Nutrition Center, Clínica Las Condes, Santiago, Chile
12. Point Medical, Dijon, France
13. University of Pisa School of Medicine, and Metabolism Unit of the National Research Council (CNR) Institute of Clinical Physiology, Pisa, Italy
14. Department of Medical and Surgical Sciences, University of Padova, Padova, Italy
15. McGill University and Center for Innovative Medicine, McGill University Health Center/Royal Victoria Hospital, Montreal, Canada
16. Department of Medicine and Irving Institute for Clinical and Translational Research, Columbia University, New York, USA
17. Weill Cornell Medical College, Cornell University, New York, USA
18. Heart Institute, People Hospital of Peking University, Beijing, China
19. Department of Diabetes and Metabolic Diseases Unit, The University of Tokyo, Tokyo, Japan
20. Department of Systems Biology and Medicine, The University of Tokyo, Tokyo, Japan
21. Human Nutritional Research Center and Department of Endocrinology, Metabolic Diseases and Nutrition, University Hospital Nantes, Nantes, France
22. Sumitomo Hospital and Osaka University, Osaka, Japan
23. University Hospital Gregorio Mara?ón, Universidad Complutense, Madrid, Spain
24. University of Concepción, Concepción, Chile
25. Department of Cardiovascular Medicine, Kumamoto University, Kumamoto, Japan
26. Brigham and Women’s Hospital and Harvard Medical School, Boston, USA
27. Division of Translational Medicine and Human Genetics, Smilow Center for Translational Research, Penn Cardiovascular Institute, Philadelphia, PA, USA
28. Jaslok Hospital and Research Center, Mumbai, India
29. Unidade Clínica de Lipides InCor-HCFMUSP, Sao Paulo, Brazil
30. Federal Almazov Heart Blood Endocrinology Centre, St Petersburg, Russia
31. Mahidol University, Bangkok, Thailand
32. University of the Philippines-Philippine General Hospital, Manila, The Philippines
33. Specialized Center of Research (SCOR) in Molecular Medicine and Atherosclerosis, Columbia University, College of Physicians & Surgeons, New York, USA
34. Gleneagles Medical Centre, Kragujevac, Singapore
35. Hacettepe University, Ankara, Turkey
36. Sterling Rock Falls Clinic, CGH Medical Center, Sterling and University of Illinois School of Medicine, Peoria, IL, USA
37. H?pital Jean Verdier, Department of Endocrinology Diabetology Nutrition, AP-HP, Paris-Nord University, CRNH-IdF, CINFO, Bondy, France
38. University Hospital Würzburg, Würzburg, Germany
39. Zhongshan Hospital, Fudan University, Shanghai, China
40. Baker IDI Heart and Diabetes Institute, Melbourne, Australia - ISSN：1475-2840
文摘
Cardiovascular disease poses a major challenge for the 21st century, exacerbated by the pandemics of obesity, metabolic syndrome and type 2 diabetes. While best standards of care, including high-dose statins, can ameliorate the risk of vascular complications, patients remain at high risk of cardiovascular events. The Residual Risk Reduction Initiative (R3i) has previously highlighted atherogenic dyslipidaemia, defined as the imbalance between proatherogenic triglyceride-rich apolipoprotein B-containing-lipoproteins and antiatherogenic apolipoprotein A-I-lipoproteins (as in high-density lipoprotein, HDL), as an important modifiable contributor to lipid-related residual cardiovascular risk, especially in insulin-resistant conditions. As part of its mission to improve awareness and clinical management of atherogenic dyslipidaemia, the R3i has identified three key priorities for action: i) to improve recognition of atherogenic dyslipidaemia in patients at high cardiometabolic risk with or without diabetes; ii) to improve implementation and adherence to guideline-based therapies; and iii) to improve therapeutic strategies for managing atherogenic dyslipidaemia. The R3i believes that monitoring of non-HDL cholesterol provides a simple, practical tool for treatment decisions regarding the management of lipid-related residual cardiovascular risk. Addition of a fibrate, niacin (North and South America), omega-3 fatty acids or ezetimibe are all options for combination with a statin to further reduce non-HDL cholesterol, although lacking in hard evidence for cardiovascular outcome benefits. Several emerging treatments may offer promise. These include the next generation peroxisome proliferator-activated receptorα agonists, cholesteryl ester transfer protein inhibitors and monoclonal antibody therapy targeting proprotein convertase subtilisin/kexin type 9. However, long-term outcomes and safety data are clearly needed. In conclusion, the R3i believes that ongoing trials with these novel treatments may help to define the optimal management of atherogenic dyslipidaemia to reduce the clinical and socioeconomic burden of residual cardiovascular risk.