[1]徐笑挺,戴承晔,邓毅凡,等.二十碳五烯酸在动脉粥样硬化性心血管疾病中的研究进展[J].心血管病学进展,2022,(12):1118.[doi:10.16806/j.cnki.issn.1004-3934.2022.12.014]
　XU Xiaoting,DAI Chengye,DENG Yifan,et al.Eicosapentaenoic Acid in Atherosclerotic Cardiovascular Disease[J].Advances in Cardiovascular Diseases,2022,(12):1118.[doi:10.16806/j.cnki.issn.1004-3934.2022.12.014]
点击复制

二十碳五烯酸在动脉粥样硬化性心血管疾病中的研究进展()
分享到：

《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2022年12期
页码:
1118
栏目:
综述
出版日期:
2022-12-25

文章信息/Info

Title:
Eicosapentaenoic Acid in Atherosclerotic Cardiovascular Disease
作者:
徐笑挺1; 2; 戴承晔1; 2; 邓毅凡2; 朱米雪1; 2; 刘娟2; 何胜虎2; 张晶2
(1.大连医科大学扬州临床医学院,江苏 扬州 225001;2.江苏省苏北人民医院心内科,江苏 扬州 225001)
Author(s):
XU Xiaoting1; 2; DAI Chengye1; 2; DENG Yifan2; ZHU Mixue1; 2; LIU Juan2; HE Shenghu2; ZHANG Jing2
(1. The Yangzhou School of Clinical Medicine of Dalian Medical University, Yangzhou 225001,Jiangsu,China2. Department of Cardiology, Subei Peoples Hospital of Jiangsu Province , Yangzhou 225001,Jiangsu,China)
关键词:
二十碳五烯酸; 二十碳五烯酸乙酯; 动脉粥样硬化性心血管疾病
Keywords:
Eicosapentaenoic acid;  icosapent ethyl;  Atherosclerotic cardiovascular disease
DOI:
10.16806/j.cnki.issn.1004-3934.2022.12.014
摘要:
他汀类药物在动脉粥样硬化性心血管疾病（ASCVD）一二级预防中起关键性作用，但部分患者正规治疗后仍存在心血管残余风险。新近研究显示甘油三酯（TG）水平升高是心血管事件增加的独立危险因素，因此降低心血管高危人群的TG水平，成为防治ASCVD的重要一环。二十碳五烯酸（EPA）是一种ω-3多不饱和脂肪酸，它能降低TG水平并通过减少炎症介质、抗氧化应激、改善内皮功能障碍、形成胆固醇晶体和稳定斑块等作用抗动脉粥样硬化进展。二十碳五烯酸乙酯（IPE）则是高纯度（EPA≥96%）EPA单分子处方药，目前已通过REDUCE-IT试验、JELIS试验、EVAPORATE试验等临床试验证明其有效性和安全性。本文章对EPA在ASCVD中的抗动脉粥样硬化机制及临床中的应用进行综述。
Abstract:
Statins have played a key role in the primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD),but some patients still have residual cardiovascular risk after regular treatment. Recent studies have shown that increased triglycerides (TG) levels were an independent risk factor for increased cardiovascular events. Therefore, reducing triglycerides levels in high cardiovascular risk groups has become an important part of the prevention and treatment of ASCVD. Eicosapentaenoic acid (EPA) is an omega-3 polyunsaturated fatty acid that reduces TG levels and prevents the progression of atherosclerosis by reducing inflammatory mediators, resisting oxidative stress, improving endothelial dysfunction, forming cholesterol crystals,and stabilizing plaques. Icosapent ethyl (IPE) is a high purity (EPA≥96%) EPA monomer prescription drug, which has been proved to be effective and safe by REDUCE-IT test, JELIS test, EVAPORATE test and other clinical tests. This article reviews the anti-atherosclerosis mechanism and clinical application of EPA in ASCVD

参考文献/References:

[1] Boden WE,Bhatt DL,Toth PP,et al. Profound reductions in first and total cardiovascular events with icosapent ethyl in the REDUCE-IT trial:why these results usher in a new era in dyslipidaemia therapeutics[J]. Eur Heart J,2020,41(24):2304-2312.

[2] Schwartz GG,Steg PG,Szarek M,et al. Alirocumab and cardiovascular outcomes after acute coronary syndrome[J]. N Engl J Med,2018,379(22):2097-2107.

[3] Nichols GA,Philip S,Reynolds K,et al. Increased residual cardiovascular risk in patients with diabetes and high versus normal triglycerides despite statin-controlled LDL cholesterol[J]. Diabetes Obes Metab,2019,21(2):366-371.

[4] Brinton EA,Mason RP. Prescription omega-3 fatty acid products containing highly purified eicosapentaenoic acid (EPA) [J]. Lipids Health Dis,2017,16(1):23.

[5] Lawler PR,Kotrri G,Koh M,et al. Real-world risk of cardiovascular outcomes associated with hypertriglyceridaemia among individuals with atherosclerotic cardiovascular disease and potential eligibility for emerging therapies[J]. Eur Heart J,2020,41(1):86-94.

[6] Picard F,Bhatt DL,Ducrocq G,et al. Generalizability of the REDUCE-IT trial in patients with stable coronary artery disease[J]. J Am Coll Cardiol,2019,73(11):1362-1364.

[7] Budoff MJ,Bhatt DL,Kinninger A,et al. Effect of icosapent ethyl on progression of coronary atherosclerosis in patients with elevated triglycerides on statin therapy:final results of the EVAPORATE trial[J]. Eur Heart J,2020,41(40):3925-3932.

[8] Rinne P,Rami M,Nuutinen S,et al. Melanocortin 1 receptor signaling regulates cholesterol transport in macrophages[J]. Circulation,2017,136(1):83-97.

[9] Mason RP,Libby P,Bhatt DL. Emerging mechanisms of cardiovascular protection for the omega-3 fatty acid eicosapentaenoic acid[J]. Arterioscler Thromb Vasc Biol,2020,40(5):1135-1147.

[10] Fredman G,Tabas I. Boosting inflammation resolution in atherosclerosis:the next frontier for therapy[J]. Am J Pathol,2017,187(6):1211-1221.

[11] Hou TY,McMurray DN,Chapkin RS. Omega-3 fatty acids,lipid rafts,and T cell signaling[J]. Eur J Pharmacol,2016,785:2-9.

[12] Reilly NA,Lutgens E,Kuiper J,et al. Effects of fatty acids on T cell function:role in atherosclerosis[J]. Nat Rev Cardiol,2021,18(12):824-837.

[13] Obama T,Itabe H. Neutrophils as a novel target of modified low-density lipoproteins and an accelerator of cardiovascular diseases[J]. Int J Mol Sci,2020,21(21):8312.

[14] Mason RP,Sherratt SC,Jacob RF. Eicosapentaenoic acid inhibits oxidation of apob-containing lipoprotein particles of different size in vitro when administered alone or in combination with atorvastatin active metabolite compared with other triglyceride-lowering agents[J]. J Cardiovasc Pharmacol,2016,68(1):33-40.

[15] Sherratt SCR,Mason RP. Eicosapentaenoic acid and docosahexaenoic acid have distinct membrane locations and lipid interactions as determined by X-ray diffraction[J]. Chem Phys Lipids,2018,212:73-79.

[16] Tong H,Rappold AG,Caughey M,et al. Dietary supplementation with olive oil or fish oil and vascular effects of concentrated ambient particulate matter exposure in human volunteers[J]. Environ Health Perspect,2015,123(11):1173-1179.

[17] Yubero-Serrano EM,Fernandez-Gandara C,Garcia-Rios A,et al. Mediterranean diet and endothelial function in patients with coronary heart disease:An analysis of the CORDIOPREV randomized controlled trial[J]. PLoS Med,2020,17(9):e1003282.

[18] Widlansky ME,Jensen DM,Wang J,et al. miR-29 contributes to normal endothelial function and can restore it in cardiometabolic disorders[J]. EMBO Mol Med,2018,10(3):e8046

[19] Mason RP,Dawoud H,Jacob RF,et al. Eicosapentaenoic acid improves endothelial function and nitric oxide bioavailability in a manner that is enhanced in combination with a statin[J]. Biomed Pharmacother,2018,103:1231-1237.

[20] Amsalem M,Poilbout C,Ferracci G,et al. Membrane cholesterol depletion as a trigger of Nav1.9 channel-mediated inflammatory pain[J]. EMBO J,2018,37(8):e97349.

[21] Huang CS,Yu X,Fordstrom P,et al. Cryo-EM structures of NPC1L1 reveal mechanisms of cholesterol transport and ezetimibe inhibition[J]. Sci Adv,2020,6(25):eabb1989.

[22] Genaro-Mattos TC,Allen LB,Anderson A,et al. Maternal aripiprazole exposure interacts with 7-dehydrocholesterol reductase mutations and alters embryonic neurodevelopment[J]. Mol Psychiatry,2019,24(4):491-500.

[23] Grebe A,Latz E. Cholesterol crystals and inflammation[J]. Curr Rheumatol Rep,2013,15(3):313.

[24] Mason RP,Jacob RF. Eicosapentaenoic acid inhibits glucose-induced membrane cholesterol crystalline domain formation through a potent antioxidant mechanism[J]. Biochim Biophys Acta,2015,1848(2):502-509.

[25] Bhatt DL,Steg PG,Miller M,et al. Cardiovascular risk reduction with icosapent ethyl for hypertriglyceridemia[J]. N Engl J Med,2019,380(1):11-22.

[26] Bhatt DL,Steg PG,Miller M,et al. Effects of icosapent ethyl on total?ischemic events:from REDUCE-IT[J]. J Am Coll Cardiol,2019,73(22):2791-2802.

[27] Yokoyama M,Origasa H,Matsuzaki M,et al. Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS):a randomised open-label,blinded endpoint analysis[J]. Lancet,2007,369(9567):1090-1198.

[28] Saito Y,Yokoyama M,Origasa H,et al. JELIS Investigators,Japan. Effects of EPA on coronary artery disease in hypercholesterolemic patients with multiple risk factors:sub-analysis of primary prevention cases from the Japan EPA Lipid Intervention Study (JELIS) [J]. Atherosclerosis,2008,200(1):135-40.

[29] Budoff MJ,Muhlestein JB,Bhatt DL,et al. Effect of icosapent ethyl on progression of coronary atherosclerosis in patients with elevated triglycerides on statin therapy:a prospective,placebo-controlled randomized trial (EVAPORATE):interim results[J]. Cardiovasc Res,2021,117(4):1070-1077.

[30] Nasir K,Bittencourt MS,Blaha MJ,et al. Implications of coronary artery calcium testing among statin candidates according to American College of Cardiology/American Heart Association Cholesterol Management Guidelines:MESA (Multi-Ethnic Study of Atherosclerosis) [J]. J Am Coll Cardiol,2015,66(15):1657-1668.

[31] Bays HE,Ballantyne CM,Kastelein JJ,et al. Eicosapentaenoic acid ethyl ester (AMR101) therapy in patients with very high triglyceride levels (from the Multi-center,plAcebo-controlled,Randomized,double-blINd,12-week study with an open-label Extension [MARINE] trial) [J]. Am J Cardiol,2011.108(5):682-690.

[32] Ballantyne CM,Bays HE,Kastelein JJ,et al. Efficacy and safety of eicosapentaenoic acid ethyl ester (AMR101) therapy in statin-treated patients with persistent high triglycerides (from the ANCHOR study) [J]. Am J Cardiol,2012.110(7):984-92.

[33] Braeckman RA,Manku MS,Bays HE,et al. Icosapent ethyl,a pure EPA omega-3 fatty acid:effects on plasma and red blood cell fatty acids in patients with very high triglyceride levels (results from the MARINE study)[J]. Prostaglandins Leukot Essent Fatty Acids,2013,89(4):195-201.

更新日期/Last Update: 2023-02-03