关于常规血脂检测的剩余风险/残留风险的相关研究已得到广泛关注,这里列举2个代表研究:Uffe Ravnskov[1]等发表在Expert Review of Clinical Pharmacology的综述认为LDL与冠心病没有任何关系,证伪了他汀的相关研究。高水平的总胆固醇(TC)或低密度脂蛋白胆固醇(LDL-C)一直被认为是动脉粥样硬化和心血管疾病(CVD)的主要原因,他汀类药物治疗已被广泛推广用于心血管预防。然而,越来越多的人认识到,其机制更为复杂,他汀类药物治疗,特别是作为一级预防时,其益处值得怀疑。发表在American Heart Journal的研究[2]数据显示常规血脂检测对动脉粥样硬化心血管疾病(ASCVD)预测性较差。 136905例冠状动脉疾病Coronary Artery Disease (CAD)住院确诊患者,45.3%的HDL-C正常,49.6%的LDL-C正常。
[1] Uffe R , Michel D L , Diamond D M ,et al.LDL-C does not cause cardiovascular disease: a comprehensive review of the current literature[J].Expert Review of Clinical Pharmacology, 2018, 11:17512433.2018.1519391-.
[2] Sachdeva A , Cannon C P , Deedwania P C ,et al.Lipid levels in patients hospitalized with coronary artery disease: An analysis of 136,905 hospitalizations in Get With The Guidelines[J].Mosby, 2009(1).