Non-statin therapy in patients with elevated LDL-C and high platelet reactivity: a narrative review.

Q3 Medicine
Medical Journal of Malaysia Pub Date : 2025-03-01
F N Nurmukhammad, B Zhangelova Sh, D A Кapsultanova, A T Musagaliyeva, L B Danyarova, F E Rustamova, A B Sugraliyev, G E Ospanova
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引用次数: 0

Abstract

Introduction: Evidence of an association between elevated LDL-C levels and HRPR - which are highly prevalent separately and both lead to rapid progression of atherosclerosis on ineffective hypolipidaemic therapy - is scarce.

Materials and methods: We searched electronic databases. All available randomized controlled trials (RCTs) were included, and we considered the scientific novelty of the study, the reliability of the reported study results; the high methodological level of the study of non-statin therapy in patients with dyslipidemia and high residual platelet reactivity, with no language or date restrictions. We did separate random-effects meta-analyses for LDL-С, HRRP on their effects on LDL-С levels and outcomes, taking into account the reliability of the reported study results and the high methodological level of the study. The challenge of achieving target LDL-С levels, their impact on high residual platelet reactivity, and the choice of optimal antiplatelet and lipid-lowering therapy remains unresolved.

Results: The integration of newer therapies, such as inclisiran and PCSK9 inhibitors, may play a critical role in achieving optimal outcomes for patients at high cardiovascular risk.

Conclusion: The necessity of applying an individual multidisciplinary approach in order to determine the best regimen of antiplatelet and lipid-lowering therapy in patients with coronary heart disease, including after revascularization, is shown. This approach will reduce the risk of recurrent cardiovascular events. Few studies on the relationship between LDL-С and HRPR dictate the need for more detailed research in this area.

非他汀类药物治疗LDL-C升高和高血小板反应性患者:叙述性回顾。
导读:低密度脂蛋白- c水平升高和HRPR之间存在关联的证据很少,这两者是非常普遍的,并且在无效的降血脂治疗下都会导致动脉粥样硬化的快速进展。材料和方法:检索电子数据库。纳入了所有可用的随机对照试验(RCTs),我们考虑了研究的科学新颖性、报告研究结果的可靠性;非他汀类药物治疗血脂异常和残余血小板反应性高的患者的高方法学水平的研究,没有语言或日期限制。考虑到报告的研究结果的可靠性和研究的高方法学水平,我们对LDL-С、HRRP对LDL-С水平和结果的影响进行了单独的随机效应荟萃分析。实现目标LDL-С水平的挑战,它们对高残余血小板反应性的影响,以及最佳抗血小板和降脂治疗的选择仍未解决。结果:新疗法的整合,如inclisiran和PCSK9抑制剂,可能在高心血管风险患者获得最佳结果方面发挥关键作用。结论:为确定冠心病患者包括血运重建术后的抗血小板和降脂治疗的最佳方案,应用多学科方法的必要性。这种方法将降低心血管事件复发的风险。关于LDL-С与HRPR之间关系的研究很少,因此需要在这一领域进行更详细的研究。
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
Medical Journal of Malaysia
Medical Journal of Malaysia Medicine-Medicine (all)
CiteScore
1.20
自引率
0.00%
发文量
165
期刊介绍: Published since 1890 this journal originated as the Journal of the Straits Medical Association. With the formation of the Malaysian Medical Association (MMA), the Journal became the official organ, supervised by an editorial board. Some of the early Hon. Editors were Mr. H.M. McGladdery (1960 - 1964), Dr. A.A. Sandosham (1965 - 1977), Prof. Paul C.Y. Chen (1977 - 1987). It is a scientific journal, published quarterly and can be found in medical libraries in many parts of the world. The Journal also enjoys the status of being listed in the Index Medicus, the internationally accepted reference index of medical journals. The editorial columns often reflect the Association''s views and attitudes towards medical problems in the country. The MJM aims to be a peer reviewed scientific journal of the highest quality. We want to ensure that whatever data is published is true and any opinion expressed important to medical science. We believe being Malaysian is our unique niche; our priority will be for scientific knowledge about diseases found in Malaysia and for the practice of medicine in Malaysia. The MJM will archive knowledge about the changing pattern of human diseases and our endeavours to overcome them. It will also document how medicine develops as a profession in the nation. We will communicate and co-operate with other scientific journals in Malaysia. We seek articles that are of educational value to doctors. We will consider all unsolicited articles submitted to the journal and will commission distinguished Malaysians to write relevant review articles. We want to help doctors make better decisions and be good at judging the value of scientific data. We want to help doctors write better, to be articulate and precise.
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