Dtsch Med Wochenschr 2015; 140(10): 761-764
DOI: 10.1055/s-0041-102254
Fachwissen
Standpunkt
© Georg Thieme Verlag KG Stuttgart · New York

LDL-Cholesterin: Von der Hypothese zur Kausalität

LDL-Cholesterol – Is there an “LDL hypothesis”?
Florian Custodis
1   Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes Homburg / Saar
,
Ulrich Laufs
1   Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes Homburg / Saar
› Author Affiliations
Further Information

Publication History

Publication Date:
13 May 2015 (online)

Zusammenfassung

Der Begriff der „LDL-Hypothese“ wird häufig verwendet um den Zusammenhang von LDL Cholesterin (LDL-C) und kardiovaskulären Ereignissen zu beschreiben. Im Hinblick auf aktuelle Studienergebnisse stellt sich die Frage, inwieweit dieser Terminus noch adäquat ist. Vor dem Hintergrund der Daten zur kausalen Bedeutung des LDL für die molekulare und zelluläre Pathogenese der Atherosklerose, der Epidemiologie und der klaren genetischen Assoziation von LDL-C und Herzinfarktrisiko sowie der großen Statin-Studien sowie dem Beleg einer Ereignis-Reduktion durch eine nicht Statin-vermittelte LDL Senkung in der IMPROVE-IT Studie erscheint der Terminus „Hypothese“ überholt und der Begriff „LDL-Kausalität“ adäquat.

Abstract

The term „LDL-Hypothesis“ is frequently used to describe the association between LDL cholesterol (LDL-C) and cardiovascular outcomes. In the light of recent results of randomized trials the question arises whether the term hypothesis is still adequate. Considering the causal importance of LDL for the pathogenesis of atherosclerosis, epidemiological evidence and the clear genetic association of LDL-C with cardiovascular risk as well as the large statin trials and the reduction of events by a non-statin intervention in the IMPROVE-IT study, the term “hypothesis” appears to be outdated and should be replaced by “LDL-causality”.

 
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