2023-06-23 インペリアル・カレッジ・ロンドン(ICL)
◆彼らは糖鎖と呼ばれる糖分子を研究し、糖鎖の微細な変化が生命に重要なプロセスに影響を与えることを解明しています。これにより、糖鎖を利用したがんバイオマーカーの標識や、SARS-CoV-2の進化経路におけるO-糖鎖の役割の発見などが可能になります。
<関連情報>
- https://www.imperial.ac.uk/news/245719/cholesterol-guidelines-menstrual-cycle-insights-news/
- https://www.sciencedirect.com/science/article/pii/S2666776223000844
欧州全域におけるアテローム性動脈硬化性心血管疾患の有無にかかわらず、2019年ESC/EAS脂質異常症ガイドラインの最適な実施:DA VINCI研究に基づくシミュレーション Optimal implementation of the 2019 ESC/EAS dyslipidaemia guidelines in patients with and without atherosclerotic cardiovascular disease across Europe: a simulation based on the DA VINCI study
Julia Brandts, Sarah Bray, Guillermo Villa, Alberico L. Catapano, Neil R. Poulter, Antonio J. Vallejo-Vaz, Kausik K. Ray on behalf of the DA VINCI study group
The Lancet Regional Health – Europe Available online: 8 June 2023
DOI:https://doi.org/10.1016/j.lanepe.2023.100665
Summary
Background
The impact of the stepwise implementation of the 2019 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) treatment algorithm on low-density lipoprotein cholesterol (LDL-C) goal attainment was simulated in patients from the DA VINCI study.
Methods
Monte Carlo simulation was used to evaluate treatment optimisation scenarios, based on a patient’s risk category: statin intensification (step 1), addition of ezetimibe (step 2), and addition of a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor (step 3). Residual cardiovascular risk and predicted relative and absolute risk reduction (RRR and ARR) in cardiovascular events were assessed.
Findings
In DA VINCI, 2482 patients did not achieve their 2019 ESC/EAS LDL-C goals and were included in the simulation. In patients without atherosclerotic cardiovascular disease (ASCVD) (n = 962), 27.0% (n = 259) and 57.0% (n = 548) are likely to achieve their LDL-C goals at step 1 and step 2, respectively. Of those at very high risk without ASCVD (n = 74), 88.1% (n = 65) are likely to achieve their LDL-C goals at step 3. In patients with ASCVD (n = 1520), 12.0% (n = 183), 42.1% (n = 641) and 93.2% (n = 1416) are likely to achieve their LDL-C goals at steps 1, 2 and 3, respectively. In patients with and without ASCVD, treatment optimisation may result in mean simulated RRR of 24.0% and 17.7%, respectively, and ARR of 8.1% and 2.6%, respectively.
Interpretation
Most patients at high cardiovascular risk are unlikely to achieve LDL-C goals through statin optimisation and ezetimibe, and will require a PCSK9 inhibitor, leading to greater reduction in cardiovascular risk.
Funding
Amgen.
