期刊
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
卷 72, 期 3, 页码 330-343出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2018.04.061
关键词
clinical trials; dyslipidemia and residual risk; hypertriglyceridemia; omega-3 fatty acids
资金
- National Institute of Diabetes and Digestive and Kidney Diseases [P30-DK036836]
- Amarin Pharma
- Abbott
- Amarin
- Amgen
- AstraZeneca
- Bristol-Myers Squibb
- Chiesi
- Eisai
- Ethicon
- Forest Laboratories
- Ironwood
- Ischemix
- Lilly
- Medtronic
- Pfizer
- Regeneron
- Roche
- Sanofi-Aventis
- Medicines Company
- Novartis
- Clinical Trials Network
- Massachusetts Veterans Epidemiology, Research, and Information Center (MAVERIC)
- VA New England Healthcare System
- NHLBI
- Axio Research, Inc.
- AbbVie
- Amarin Pharmaceuticals. Inc.
- Sanofi
Despite the important role of high-intensity statins in reducing atherosclerotic cardiovascular disease events in secondary and primary prevention, substantial residual risk persists, particularly among high-risk patients with type 2 diabetes mellitus, metabolic syndrome, and obesity. Considerable attention is currently directed to the role that elevated triglycerides (TGs) and non-high-density lipoprotein cholesterol levels play as important mediators of residual atherosclerotic cardiovascular disease risk, which is further strongly supported by genetic linkage studies. Previous trials with fibrates, niacin, and most cholesterol ester transfer protein inhibitors that targeted high-density lipoprotein cholesterol raising, and/or TG lowering, have failed to show conclusive evidence of incremental event reduction after low-density lipoprotein cholesterol levels were optimally controlled with statins. Although omega-3 fatty acids are efficacious in lowering TG levels and may have pleiotropic effects such as reducing plaque instability and proinflammatory mediators of atherogenesis, clinical outcomes data are currently lacking. Several ongoing randomized controlled trials of TG-lowering strategies with an optimal dosage of omega-3 fatty acids are nearing completion. (C) 2018 by the American College of Cardiology Foundation.
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