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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2018.1
- 수록면
- 12 - 20 (9page)
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Recent clinical trials and meta-analyses have indicated that high-intensive statin treatment lowers low-density lipoprotein cholesterol (LDL-C) levels and reduces the risk of nonfatal cardiovascular (CV) events compared with moderate-intensity statin treatment. However, there are residual risks of CV events and safety concerns associated with high-intensity statin treatment. The Improved Reduction of Outcomes: Vytorin Efficacy International Trial (IMPROVE-IT) study showed that ezetimibe plus moderate-intensity statin therapy after acute coronary syndromes incrementally lowers LDL-C levels and improved CV outcomes compared with moderate-intensity statin therapy. However, despite the LDL-C-lowering effects, a substantial residual CV risk still remains, which includes other lipid abnormalities such as low high-density lipoprotein cholesterol (HDL-C). The most representative agents that primarily increase HDL-C are cholesteryl ester transfer protein (CETP) inhibitors. Until now, 4 CETP inhibitors, including torcetrapib, dalcetrapib, evacetrapib, and anacetrapib, have been introduced and all have significantly raised the HDL-C from 30% to 133%. However, the results for CV outcomes in clinical trials differed, based on the 4 agents. Torcetrapib increased the risk of CV events and total mortality in patients at high CV risk (ILLUMINATE trial). Dalcetrapib and evacetrapib did not result in lower rate of CV events in patients with recent acute coronary syndrome and high risk vascular disease, respectively (dal-OUTCOMES and ACCELERATE trials). However, anacetrapib significantly decreased the incidence of major coronary events in patients with atherosclerotic vascular disease (REVEAL trial). This topic summarizes the major results of recent statin and CETP inhibitor trials and provides framework to interpret and implement the trial results in real clinical practice.
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참고문헌 (26)
참고문헌 신청
Catapano AL / 2016 / 2016 ESC/EAS guidelines for the management of dyslipidemias / Eur Heart J 37:2999~3058
Stone NJ / 2014 / 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines / J Am Coll Cardiol 63(25):2889~2934
Cholesterol Treatment Trialists' (CTT) CollaborationBaigent C / 2010 / Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials / Lancet 376:1670~1681
Preiss D / 2011 / Risk of incident diabetes with intensive-dose compared with moderate-dose statin therapy: a meta-analysis / JAMA 305:2556~2564
Collins R / 2016 / Interpretation of the evidence for the efficacy and safety of statin therapy / Lancet 388:2532~2561
Stone NJ / 2014 / 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines / J Am Coll Cardiol 63(25):2889~2934
Cholesterol Treatment Trialists' (CTT) CollaborationBaigent C / 2010 / Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials / Lancet 376:1670~1681
Preiss D / 2011 / Risk of incident diabetes with intensive-dose compared with moderate-dose statin therapy: a meta-analysis / JAMA 305:2556~2564
Collins R / 2016 / Interpretation of the evidence for the efficacy and safety of statin therapy / Lancet 388:2532~2561
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