Triglycerides and cardiovascular risk

摘要

Accumulation of cholesterol-rich lipopro-teins, notably low-density lipoprotein (LDL) cholesterol, in the subendothelial matrix of the artery wall is a key pathological process in atherosclerosis. There is overwhelming evidence that lowering plasma LDL cholesterol concentrations with statins reduces future cardiovascular events, and the effect is proportional to the degree by which LDL cholesterol concentration is lowered. Guidelines recommend aggressive LDL reduction in the secondary prevention of coronary artery disease (CAD), but, despite this and the control of other well-established risk factors, such patients, particularly after an acute coronary syndrome (ACS), remain at substantial residual risk of further events. In patients treated with statins, the risk of recurrent events increases in proportion to the number of components of the metabolic syndrome that they exhibit. Clearly other factors, including other lipoprotein abnormalities that are not significantly affected by statins, are of importance in promoting atherosclerosis.