LDL-Cholesterin: Von der Hypothese zur Kausalität

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and the reduction of events by a non-statin intervention in the IMPROVE-IT study, the term “hypothesis” appears to be outdated and should be replaced by “LDL-causality”.

Schlüsselwörter

LDL - Cholesterin - LDL-Hypothese - IMPROVE-IT

Keywords

LDL - Cholesterol - LDL-Hypothesis - IMPROVE-IT

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