Remnant Cholesterol: Should it be a Target for Prevention of ASCVD?

IF 5.7 2区医学 Q1 PERIPHERAL VASCULAR DISEASE

Current Atherosclerosis Reports Pub Date : 2025-03-25 DOI:10.1007/s11883-025-01288-w

Takahito Doi, Anne Langsted, Børge Grønne Nordestgaard

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引用次数: 0

Abstract

Purpose of review: To summarize studies analyzing whether remnant cholesterol should be a target for prevention of atherosclerotic cardiovascular disease (ASCVD).

Recent findings: There is a growing body of evidence from epidemiologic and Mendelian randomization studies implicating remnant cholesterol as a causal risk factor for ASCVD. However, the results of randomized controlled trials, particularly those conducted in the current high-intensity statin era, have been inconsistent. Most recently, the PROMINENT trial failed to show a beneficial effect of 0.4 mg/day of pemafibrate on the risk of ASCVD. In the Copenhagen General Population Study (CGPS), which mimics PROMINENT, the estimated hazard ratio for ASCVD was 1.05 (0.96-1.14) when absolute changes in remnant cholesterol, LDL cholesterol, and apolipoprotein B were combined, whereas the hazard ratio for ASCVD in PROMINENT was 1.03 (0.91-1.15). Further trials are warranted to ascertain the efficacy of novel remnant cholesterol- and triglyceride-lowering agents in the prevention of ASCVD. To reduce ASCVD, active agents need to reduce total atherogenic cholesterol (LDL and remnant cholesterol) and apolipoprotein B.

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残余胆固醇：它应该是预防ASCVD的目标吗？

综述目的：总结分析残余胆固醇是否应该作为预防动脉粥样硬化性心血管疾病（ASCVD）的靶点的研究。最新发现：流行病学和孟德尔随机化研究中越来越多的证据表明残余胆固醇是ASCVD的一个因果危险因素。然而，随机对照试验的结果，特别是在当前高强度他汀类药物时代进行的试验，一直不一致。最近，著名的试验未能显示0.4 mg/天的培马颤对ASCVD风险的有益影响。在哥本哈根普通人群研究（CGPS）中，当残余胆固醇、低密度脂蛋白胆固醇和载脂蛋白B的绝对变化相结合时，ASCVD的估计风险比为1.05(0.96-1.14)，而PROMINENT的ASCVD的风险比为1.03（0.91-1.15）。需要进一步的试验来确定新型残余胆固醇和甘油三酯降低剂在预防ASCVD中的功效。为了减少ASCVD，活性药物需要降低总致动脉粥样硬化胆固醇（LDL和残余胆固醇）和载脂蛋白B。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Atherosclerosis Reports 医学-

CiteScore

9.00

自引率

3.40%

发文量

审稿时长

6-12 weeks

期刊介绍： The aim of this journal is to systematically provide expert views on current basic science and clinical advances in the field of atherosclerosis and highlight the most important developments likely to transform the field of cardiovascular prevention, diagnosis, and treatment. We accomplish this aim by appointing major authorities to serve as Section Editors who select leading experts from around the world to provide definitive reviews on key topics and papers published in the past year. We also provide supplementary reviews and commentaries from well-known figures in the field. An Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research.