Einfluss der Lipidstoffwechselparameter auf die Entstehung und Progression der koronaren Herzerkrankung

Abstract

Disorders of lipid metabolism play a major role in the development and progression of coronary artery disease. Dyslipidemia therefore plays a central role in therapeutic approaches for prevention and treatment of cardiovascular events associated with coronary artery disease. Epidemiological studies have shown an association between various lipid metabolism parameters, the risk of developing coronary artery disease and progression of a pre-existing disease. In particular, increased levels of low-density lipoprotein cholesterol (LDL-C), reduced levels of HDL cholesterol (HDL-C), as well as high levels of triglycerides and increased lipoprotein(a) [Lp(a)] levels can be taken into account when assessing the risk stratification of patients for primary prevention of coronary artery disease. Lifestyle and dietary changes, intensified statin therapy and possibly the addition of ezetimibe remain the major interventions in both primary and secondary prevention of coronary artery disease, as they improve the prognosis particularly by lowering levels of LDL-C. Recently, genetic studies have contributed to extending our understanding of the relationship between lipid metabolism and coronary artery disease. A causal role for progression of coronary artery disease could be demonstrated for LDL-C, Lpa and triglyceride-rich lipoproteins (TRL), which could not be demonstrated for HDL-C in various studies. Furthermore, the effect of reduction of LDL-C by proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibition and by the cholesteryl ester transfer protein (CETP) inhibitor anacetrapib on cardiovascular events is currently being investigated in large clinical outcome study programs.

Identification of the molecular subgroups in coronary artery disease by gene expression profiles

“…In comparison with previous studies (Mathes & Thiery, 2005;Nakamura et al, 2015;Sinning, Leistner, & Landmesser, 2016), the subgroup-specific functional modules and pathways not only confirmed the deregulated pathways in CAD, but also connected specific pathways to CAD subjects in the specific subgroup or clinical characteristics. For example, it was well recognized that lipid metabolism played an important role in the development of atherosclerosis.…”

Case Report: Neurological adverse events in subject with myasthenia gravis after PCSK9 inhibitor administration

“…Disturbances in lipid metabolism are a serious risk factor for the development of atherosclerotic cardiovascular disease ( 1 ). HMGCoA reductase inhibitors (statins) are widely used and represent the gold standard in the treatment of dyslipidaemia ( 2 ).…”