2024年8月30日~9月2日，欧洲心脏病学会年会（ESC2024）于英国伦敦盛大召开，世界各地的心血管专业人士齐聚一堂，分享最新研究成果和临床经验，共同为推动心血管领域进步贡献智慧。血脂管理作为心血管疾病（CVD）的重要危险因素之一，依旧是全场焦点和热点，该领域大量最新研究结果发布，全面涵盖血脂管理现状、最新降脂理念更新、新靶点研究进展及创新药物如小干扰RNA（siRNA）英克司兰的最新数据等，本文邀您一起游览这片血脂前沿的璀璨星河！
一、长期血脂达标挑战悬而未决，最新数据揭示亟需改善之处
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临床困局：ACS患者出院1年后，高达90%患者LDL-C不达标
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临床困局：目前降脂方案远远无法满足长期血脂管理需求
表1. 最后一次就诊时LDL-C未达标的时间和比例
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降脂新理念：LDL-C累积暴露早期即影响动脉功能，需更早更强更长久管理
图1. LDL-C累积暴露量与动脉粥样硬化进展的关系
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国内外最新指南均强调更严格的血脂目标，呼吁长期血脂达标
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ESC最新研究现曙光，降脂新疗法助力ASCVD患者破解长期达标困局
图2. 第90~330天的LDL-C累积暴露量
图3. 第330天时不同亚组的LDL-C达标率
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Lp(a)作为CVD独立危险因素再次被验证
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降低TG或迎来新的核酸药物
*英克司兰首针后第3个月需注射第2针，随后每半年一针。
参考文献
1. JING Yang, et al. Sex differences in atherogenic lipid profile following acute coronary syndrome. Presented at Moderated ePosters, 31 August, ESC Congress 2024.
2. S Oh, et al. Temporal trends in lipid management among Korean patients following acute myocardial infarction from 2011 to 2020. Presented at Moderated ePosters, 2 September, ESC Congress 2024.
3. C Gavina, et al. Lipid-lowering prescription patterns after a non-fatal acute coronary syndrome. Presented at Moderated ePosters, 30 August, ESC Congress 2024.
4. GF Watts, et al. LDL-C target attainment and statin use in patients with ASCVD, familial hypercholesterolaemia and those otherwise at moderate to high-risk of ASCVD in Australian general practice (SCOPE-GP). Presented at ESC Congress 2024.
5. 2022年胸痛中心数据初步探查：从当前降脂现状看临床未满足需求. https://mp.weixin.qq.com/s/aFN6tkQcukRbjZo5YQNR-w
6. Ference BA, et al. J Am Coll Cardiol. 2018; 72(10): 1141-1156.
7. T Yamaji, et al. Relationship of cumulative low-density lipoprotein cholesterol with atherosclerosis. Presented at Abstract Sessions, 31 August, ESC Congress 2024.
8. C Follonier, et al. Association between achieved cholesterol levels and the risk of major adverse cardiovascular events after acute coronary syndromes. Presented at Abstract Sessions, 30 August, ESC Congress 2024.
9. 中国血脂管理指南修订联合专家委员会. 中国循环杂志. 2023; 38(3): 237-270.
10. Vrints C, et al. 2024 ESC Guidelines for the management of chronic coronary syndromes. Eur Heart J. 2024 Aug 30: ehae177. doi: 10.1093/eurheartj/ehae177. Epub ahead of print.
11. Koren MJ, et al. J Am Coll Cardiol. 2024; 83(20): 1939-1952.
12. F Rodriguez, et al. Low-density lipoprotein cholesterol goal attainment with "inclisiran first" versus usual care in patients with atherosclerotic cardiovascular disease. Presented at Moderated ePosters, 30 August, ESC Congress 2024.
13. M Koren, et al. Lipid goal attainment across baseline socioeconomic and clinical factors comparing an "inclisiran first" implementation strategy and usual care: subgroup analysis of VICTORION-INITIATE. Presented at Moderated ePosters, 30 August, ESC Congress 2024.
14. J Sangha, et al. Lipoprotein (a), coronary artery disease risk, and MACE in individuals without standard modifiable risk factors in the UK Biobank. Presented at Award Sessions, 31 August, ESC Congress 2024.
15. DG Gaudet, et al. Rationale and design of the SHASTA-3 and SHASTA-4 studies: randomized, double-blind, placebo-controlled, phase 3 studies of plozasiran in patients with severe hypertriglyceridemia. Presented at Moderated ePosters, 30 August, ESC Congress 2024.
16. DG Gaudet, et al. Transition of patients with familial chylomicronaemia syndrome from volanesorsen to olezarsen: safety and pharmacokinetic results. Presented at Moderated ePosters, 1 September, ESC Congress 2024.
17. Z Xie, et al. SHR-1918, a monoclonal antibody against angiopoietin-like 3, in healthy subjects: a randomized, double-blind, placebo-controlled, phase 1 study. Presented at Abstract Sessions, 1 September, ESC Congress 2024.
声明：本文仅供医疗卫生专业人士了解最新医药资讯参考使用，不代表本平台观点。该信息不能以任何方式取代专业的医疗指导，也不应被视为诊疗建议，如果该信息被用于资讯以外的目的，本站及作者不承担相关责任。
（来源：《国际循环》编辑部）
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