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08.04.2024 | Invited Review Article

Drug intervention as an emerging concept for secondary prevention in patients with coronary disease

verfasst von: Yoshiyasu Minami, Junya Ako, Kenichi Tsujita, Hiroyoshi Yokoi, Yuji Ikari, Yoshihiro Morino, Yoshio Kobayashi, Ken Kozuma

Erschienen in: Cardiovascular Intervention and Therapeutics

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Abstract

Non-culprit lesion-related coronary events are a significant concern in patients with coronary artery disease (CAD) undergoing coronary intervention. Since several studies using intra-coronary imaging modalities have reported a high prevalence of vulnerable plaques in non-culprit lesions at the initial coronary event, the immediate stabilization of these plaques by intensive pharmacological regimens may contribute to the reduction in the adverse events. Although current treatment guidelines recommend the titration of statin and other drugs to attain the treatment goal of low-density lipoprotein cholesterol (LDL-C) level in patients with CAD, the early prescription of strong LDL-C lowering drugs with more intensive regimen may further reduce the incidence of recurrent cardiovascular events. In fact, several studies with intensive regimen have demonstrated a higher percentage of patients with the attainment of LDL-C treatment goal in the early phase following discharge. In addition to many imaging studies showing plaque stabilization by LDL-C lowering drugs, several recent reports have shown the efficacy of early statin and proprotein convertase subtilisin/kexin type 9 inhibitors on the immediate stabilization of non-culprit coronary plaques. To raise awareness regarding this important concept of immediate plaque stabilization and subsequent reduction in the incidence of recurrent coronary events, the term ‘Drug Intervention’ has been introduced and gradually applied in the clinical field, although a clear definition is lacking. The main target of this concept is patients with acute coronary syndrome as a higher prevalence of vulnerable plaques in non-culprit lesions in addition to the worse clinical outcomes has been reported in recent imaging studies. In this article, we discuss the backgrounds and the concept of drug intervention.

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Metadaten
Titel
Drug intervention as an emerging concept for secondary prevention in patients with coronary disease
verfasst von
Yoshiyasu Minami
Junya Ako
Kenichi Tsujita
Hiroyoshi Yokoi
Yuji Ikari
Yoshihiro Morino
Yoshio Kobayashi
Ken Kozuma
Publikationsdatum
08.04.2024
Verlag
Springer Nature Singapore
Erschienen in
Cardiovascular Intervention and Therapeutics
Print ISSN: 1868-4300
Elektronische ISSN: 1868-4297
DOI
https://doi.org/10.1007/s12928-024-00994-7

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