{"id":254609,"date":"2024-12-30T18:10:52","date_gmt":"2024-12-30T17:10:52","guid":{"rendered":"https:\/\/r3i.org\/r3i%e7%a4%be%e8%aa%ac\/%e7%a4%be%e8%aa%ac-09-21-%e6%ae%8b%e7%95%99%e8%a1%80%e7%ae%a1%e3%83%aa%e3%82%b9%e3%82%af%ef%bc%9a%e4%bd%95%e3%81%8c%e9%87%8d%e8%a6%81%e3%81%8b%ef%bc%9f\/"},"modified":"2025-02-22T16:54:27","modified_gmt":"2025-02-22T15:54:27","slug":"%e7%a4%be%e8%aa%ac-09-21-%e6%ae%8b%e7%95%99%e8%a1%80%e7%ae%a1%e3%83%aa%e3%82%b9%e3%82%af%ef%bc%9a%e4%bd%95%e3%81%8c%e9%87%8d%e8%a6%81%e3%81%8b%ef%bc%9f","status":"publish","type":"page","link":"https:\/\/r3i.org\/ja\/r3i%e7%a4%be%e8%aa%ac\/%e7%a4%be%e8%aa%ac-09-21-%e6%ae%8b%e7%95%99%e8%a1%80%e7%ae%a1%e3%83%aa%e3%82%b9%e3%82%af%ef%bc%9a%e4%bd%95%e3%81%8c%e9%87%8d%e8%a6%81%e3%81%8b%ef%bc%9f\/","title":{"rendered":"\u793e\u8aac 09\/21 – \u6b8b\u7559\u8840\u7ba1\u30ea\u30b9\u30af\uff1a\u4f55\u304c\u91cd\u8981\u304b\uff1f"},"content":{"rendered":"

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R3i\u793e\u8aac<\/h2>\n

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2021\u5e749\u6708<\/span><\/h5>\n
\u6b8b\u5b58\u8840\u7ba1\u30ea\u30b9\u30af\uff1a\u4f55\u304c\u91cd\u8981\u304b\uff1f<\/span><\/h5>\n
Prof. Jean Charles Fruchart, Prof. Michel Hermans, Prof. Pierre Amarenco<\/h6>\n

The Residual Risk Reduction Initiative\uff08R3i\uff09\u306f\u3001\u6b8b\u5b58\u8840\u7ba1\u30ea\u30b9\u30af\u306e\u91cd\u8981\u6027\u306b\u6ce8\u76ee\u3057\u3001\u3053\u306e\u5206\u91ce\u3092\u30ea\u30fc\u30c9\u3057\u3066\u304d\u305f<\/span>1,2<\/sup>\u3002\u3053\u306e\u30ea\u30b9\u30af\u306b\u306f\u5927\u8840\u7ba1\u3068\u5fae\u5c0f\u8840\u7ba1\u306e\u4e21\u65b9\u306e\u6b8b\u5b58\u30ea\u30b9\u30af\u304c\u542b\u307e\u308c\u3066\u304a\u308a\u3001\u5f8c\u8005\u306f\u3001\u7db2\u819c\u75c7\u3001\u814e\u75c7\u3001\u4e0b\u80a2\u5408\u4f75\u75c7\u306b\u3088\u308b\u5207\u65ad\u306a\u3069\u306e\u5927\u304d\u306a\u8ca0\u8377\u3092\u3082\u305f\u3089\u3059\u7cd6\u5c3f\u75c5\u6027\u5fae\u5c0f\u8840\u7ba1\u5408\u4f75\u75c7\u306e\u7ba1\u7406\u306b\u6df1\u304f\u95a2\u4e0e\u3057\u3066\u3044\u308b\u3002\u6700\u8fd1\u3001\u300c\u6b8b\u5b58\u8840\u7ba1\u30ea\u30b9\u30af\u300d\u304c\u81e8\u5e8a\u9818\u57df\u306e\u8f9e\u66f8\u306b\u5b9a\u7740\u3057\u3066\u304d\u305f\u3053\u3068\u304b\u3089<\/span>3<\/sup>\u3001\u4eca\u3001\u6539\u3081\u3066\u4e00\u6b69\u4e0b\u304c\u3063\u3066\u3001\u3053\u306e\u30ea\u30b9\u30af\u306e\u539f\u56e0\u306b\u3064\u3044\u3066\u4f55\u304c\u5206\u304b\u3063\u3066\u3044\u3066\u3001\u4eca\u5f8c\u4f55\u3092\u77e5\u308b\u5fc5\u8981\u304c\u3042\u308b\u304b\u3092\u898b\u76f4\u3059\u826f\u3044\u6642\u671f\u304c\u304d\u3066\u3044\u308b\u3002<\/span><\/p>\n

\u3053\u308c\u307e\u3067\u306f\u3001\u4f4e\u6bd4\u91cd\u30ea\u30dd\u86cb\u767d\u30b3\u30ec\u30b9\u30c6\u30ed\u30fc\u30eb\uff08LDL-C\uff09\u4ee5\u5916\u306e\u5fc3\u8840\u7ba1\u30ea\u30b9\u30af\u306e\u8981\u56e0\u3092\u7279\u5b9a\u3059\u308b\u3053\u3068\u306b\u7279\u306b\u91cd\u70b9\u304c\u7f6e\u304b\u308c\u3066\u304d\u305f\u3002 \u8840\u6f3f\u30c8\u30ea\u30b0\u30ea\u30bb\u30ea\u30c9\uff08TG\uff09\u306e\u4e0a\u6607\u3001\u9ad8\u6bd4\u91cd\u30ea\u30dd\u86cb\u767d\u30b3\u30ec\u30b9\u30c6\u30ed\u30fc\u30eb\uff08HDL-C\uff09\u306e\u8840\u6f3f\u4e2d\u6fc3\u5ea6\u306e\u4f4e\u4e0b\u3001\u5c0f\u3055\u304f\u3066\u9ad8\u5bc6\u5ea6\u306eLDL\u7c92\u5b50\u306e\u512a\u52e2\u306a\u3069\u306b\u3088\u3063\u3066\u7279\u5fb4\u3064\u3051\u3089\u308c\u305f\u52d5\u8108\u786c\u5316\u6027\u8102\u8cea\u7570\u5e38\u75c7\u306f\u3001\u9ad8\u30ea\u30b9\u30af\u8005\u306e10\u301c15\uff05\u306b\u8a8d\u3081\u3089\u308c\u3001\u7279\u306b2\u578b\u7cd6\u5c3f\u75c5\u306e\u5408\u4f75\u60a3\u8005\u3067\u8a8d\u3081\u3089\u308c\u308b<\/span>4\u301c6<\/sup>\u3002\u8840\u6f3fHDL-C\u306e\u4f4e\u5024\u304c\u5fc3\u8840\u7ba1\u30ea\u30b9\u30af\u306e\u30de\u30fc\u30ab\u30fc\u3067\u3042\u308a\u3001SCORE\u30ea\u30b9\u30af\u8a55\u4fa1\u306b\u3082\u542b\u307e\u308c\u3066\u3044\u308b\u3053\u3068\u304b\u3089<\/span>7<\/sup>\u3001\u521d\u671f\u306b\u306fHDL-C\u306b\u6ce8\u76ee\u304c\u96c6\u307e\u3063\u3066\u3044\u305f\u304c\u3001HDL\u3092\u6a19\u7684\u3068\u3057\u305f\u65b0\u898f\u6cbb\u7642\u6cd5\u306e\u30a2\u30a6\u30c8\u30ab\u30e0\u30fb\u30b9\u30bf\u30c7\u30a3\u306e\u5931\u6557\u3068\u3001\u907a\u4f1d\u5b50\u7814\u7a76\u3067\u3082\u95a2\u9023\u6027\u306e\u6b20\u5982\u304c\u8a3c\u660e\u3055\u308c\u305f\u3053\u3068\u304b\u3089<\/span>2<\/sup>\u3001TG\u304c\u6ce8\u76ee\u3055\u308c\u308b\u3088\u3046\u306b\u306a\u3063\u305f\u3002\u3057\u304b\u3057TG\u306f\u3001\u672c\u6765\u306e\u539f\u56e0\u3068\u601d\u308f\u308c\u308bTG-rich\u30ea\u30dd\u86cb\u767d\u3068\u305d\u306e\u30ec\u30e0\u30ca\u30f3\u30c8\u306e\u30b5\u30ed\u30b2\u30fc\u30c8\u3067\u3042\u308a\u3001\u3057\u3070\u3057\u3070\u30ec\u30e0\u30ca\u30f3\u30c8\u30b3\u30ec\u30b9\u30c6\u30ed\u30fc\u30eb\u3092\u7528\u3044\u3066\u6e2c\u5b9a\u3055\u308c\u308b\u3053\u3068\u306b\u7559\u610f\u304c\u5fc5\u8981\u3067\u3042\u308b<\/span>8<\/sup>\u3002<\/span><\/p>\n

TG\u95a2\u9023\u306e\u4ee3\u8b1d\u306fLDL\u4ee3\u8b1d\u3088\u308a\u8907\u96d1\u3067\u3042\u308b\u305f\u3081\u3001TG\uff08\u307e\u305f\u306fTG-rich\u30ea\u30dd\u86cb\u767d\u3068\u305d\u306e\u30ec\u30e0\u30ca\u30f3\u30c8\uff09\u306e\u56e0\u679c\u95a2\u4fc2\u3092\u78ba\u7acb\u3059\u308b\u3053\u3068\u306f\u56f0\u96e3\u3067\u3042\u308b\u3002\u307e\u305f\u3001ACCORD Lipid\u00a0<\/span>6<\/sup>\u306b\u4ee3\u8868\u3055\u308c\u308b\u3088\u3046\u306a\u3001\u5fc3\u8840\u7ba1\u30a2\u30a6\u30c8\u30ab\u30e0\u7814\u7a76\u306e\u5b9f\u65bd\u306b\u304a\u3044\u3066\u3001\u7279\u306bLDL-C\u5024\u304c\u826f\u597d\u306b\u30b3\u30f3\u30c8\u30ed\u30fc\u30eb\u3055\u308c\u3066\u3044\u308b\u306b\u3082\u304b\u304b\u308f\u3089\u305a\u3001TG\u5024\u304c\u660e\u78ba\u306b\u4e0a\u6607\u3057\u3066\u3044\u308b\u60a3\u8005\u3092\u30ea\u30af\u30eb\u30fc\u30c8\u3059\u308b\u3053\u3068\u304c\u96e3\u3057\u3044\u3068\u3055\u308c\u3066\u304d\u305f\u3002\u3053\u308c\u3089\u306e\u969c\u5bb3\u306b\u3082\u304b\u304b\u308f\u3089\u305a\u3001TG-rich\u30ea\u30dd\u86cb\u767d\u304c\u52d5\u8108\u786c\u5316\u6027\u5fc3\u8840\u7ba1\u75be\u60a3\u306e\u767a\u75c7\u7d4c\u8def\u306b\u304a\u3044\u3066\u4e00\u5b9a\u306e\u5f79\u5272\u3092\u679c\u305f\u3057\u3066\u3044\u308b\u3068\u3044\u3046\u30a8\u30d3\u30c7\u30f3\u30b9\u304c\u84c4\u7a4d\u3055\u308c\u3066\u304d\u305f<\/span>9<\/sup>\u3002\u307e\u305f\u3001TG\u5024\u306e\u8abf\u7bc0\u306b\u95a2\u4e0e\u3059\u308b\u69d8\u3005\u306a\u30bf\u30f3\u30d1\u30af\u8cea\u306e\u767a\u73fe\u306b\u5f71\u97ff\u3092\u53ca\u307c\u3059\u907a\u4f1d\u5b50\u5909\u7570\u3092\u8a55\u4fa1\u3059\u308b\u907a\u4f1d\u5b66\u7684\u7814\u7a76\u306f\u3001\u91cd\u8981\u306a\u88cf\u4ed8\u3051\u3068\u306a\u3063\u3066\u304a\u308a(10)\u3001\u9ad8TG\u8840\u75c7\u3092\u7ba1\u7406\u3059\u308b\u305f\u3081\u306e\u65b0\u898f\u6cbb\u6cd5\u306e\u958b\u767a\u306b\u3082\u8ca2\u732e\u3057\u3066\u3044\u308b\u3002<\/span><\/p>\n

\u4e00\u65b9\u3067\u3001TG\u5024\u306e\u4e0a\u6607\u304c\u81e8\u5e8a\u7684\u306b\u91cd\u8981\u3068\u306a\u308b\u30ec\u30d9\u30eb\u3092\u7279\u5b9a\u3059\u308b\u3068\u3044\u3046\u91cd\u8981\u306a\u8ab2\u984c\u304c\u7279\u306b\u6b8b\u3055\u308c\u3066\u3044\u308b\u3002\u3053\u306e\u70b9\u306b\u95a2\u3057\u3066\u306f\u3001PESA\uff08Progression of Early Subclinical Atherosclerosis\uff09\u8a66\u9a13\u304b\u3089\u5f97\u3089\u308c\u305f\u6700\u8fd1\u306e\u77e5\u898b\u304c\u53c2\u8003\u306b\u306a\u308b\u3002PESA\u8a66\u9a13\u306f\u3001\u4eca\u6708\u306e\u30d5\u30a9\u30fc\u30ab\u30b9\u3067\u8ff0\u3079\u305f\u3088\u3046\u306b\u3001TG\u5024150mg\/dL\uff081.7mmol\/L\uff09\u304b\u3089\u3001\u7121\u75c7\u5019\u6027\u30a2\u30c6\u30ed\u30fc\u30e0\u6027\u52d5\u8108\u786c\u5316\u75c7\u304c\u5897\u52a0\u3059\u308b\u3068\u3044\u3046\u77e5\u898b\u3092\u793a\u3057\u3066\u3044\u308b<\/span>11<\/sup>\u3002\u3057\u304b\u3057\u3001LDL-C\u5024\u304c\u9069\u5207\u306b\u30b3\u30f3\u30c8\u30ed\u30fc\u30eb\u3055\u308c\u305f\u72b6\u6cc1\u3067\u3001\u4e0a\u6607\u3057\u305fTG\u5024\u3092\u4f4e\u4e0b\u3055\u305b\u308b\u3053\u3068\u304c\u5fc3\u8840\u7ba1\u30a4\u30d9\u30f3\u30c8\u3092\u6e1b\u5c11\u3055\u305b\u308b\u3068\u3044\u3046\u5fc3\u8840\u7ba1\u30a2\u30a6\u30c8\u30ab\u30e0\u7814\u7a76\u306e\u30a8\u30d3\u30c7\u30f3\u30b9\u304c\u4e0d\u5341\u5206\u3067\u3042\u308b\u305f\u3081\u3001\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u3067\u306fTG\u5024\u306e\u76ee\u6a19\u5024\u3092\u5b9a\u3081\u3066\u3044\u306a\u3044<\/span>7<\/sup>\u3002PROMINENT\uff08Pemafibrate to Reduce Cardiovascular Outcomes by Reducing Triglycerides in Patients with Diabetes\uff09\u306f\u3001\u3053\u306e\u4e0d\u78ba\u5b9f\u6027\u3092\u89e3\u6c7a\u3059\u308b\u4e0a\u3067\u91cd\u8981\u306a\u5f79\u5272\u3092\u679c\u305f\u3059\u3060\u308d\u3046<\/span>12<\/sup>\u3002<\/span><\/p>\n

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TG\u4ee5\u5916\u306b\u3082\u3001\u6b8b\u5b58\u5fc3\u8840\u7ba1\u30ea\u30b9\u30af\u306e\u8981\u56e0\u306f\u3042\u308b\u3002\u9ad8\u30ea\u30b9\u30af\u60a3\u8005\u306e25\uff05\u306b\u5f71\u97ff\u3092\u53ca\u307c\u3059\u6b8b\u5b58\u708e\u75c7\u6027\u30ea\u30b9\u30af\u3092\u30bf\u30fc\u30b2\u30c3\u30c8\u3068\u3059\u308b\u610f\u7fa9\u306b\u3064\u3044\u3066\u306f\u3001\u30b3\u30f3\u30bb\u30d7\u30c8\u691c\u8a3c\u8a66\u9a13\u3067\u3042\u308bCANTOS\uff08Canakinumab Antiinflammatory Thrombosis Outcome Study\uff09\u3067\u691c\u8a3c\u3055\u308c\u3066\u3044\u308b<\/span>13,14<\/sup>\u3002\u307e\u305f\u3001COMPASS\u8a66\u9a13\uff08Cardiovascular Outcomes for People using Anticoagulation Strategies\uff09\u3067\u306f\u3001\u4f4e\u7528\u91cf\u306e\u30ea\u30d0\u30fc\u30ed\u30ad\u30b5\u30d0\u30f3\u3068\u30a2\u30b9\u30d4\u30ea\u30f3\u306e\u4f75\u7528\u306b\u3088\u308a\u3001\u5b89\u5b9a\u3057\u305f\u52d5\u8108\u786c\u5316\u6027\u5fc3\u8840\u7ba1\u60a3\u8005\u306e\u5fc3\u8840\u7ba1\u30a4\u30d9\u30f3\u30c8\u3068\u4e0b\u80a2\u306e\u4e3b\u8981\u6709\u5bb3\u4e8b\u8c61\u306e\u6709\u610f\u306a\u6e1b\u5c11\u304c\u793a\u3055\u308c\u305f\u3053\u3068\u304b\u3089\u3001\u8840\u6813\u30ea\u30b9\u30af\u306e\u6b8b\u5b58\u3082\u8003\u616e\u3059\u308b\u5fc5\u8981\u304c\u3042\u308b<\/span>15<\/sup>\u3002\u4ed6\u306e\u30ea\u30dd\u86cb\u767d\u3084\u8102\u8cea\u3082\u95a2\u4e0e\u3057\u3066\u3044\u308b\u53ef\u80fd\u6027\u304c\u3042\u308a\u3001\u305d\u306e\u56e0\u5b50\u306e1\u3064\u3068\u8003\u3048\u3089\u308c\u3066\u3044\u308b\u30ea\u30dd\u86cb\u767d(a)\u306b\u3064\u3044\u3066\u306f\u3001\u73fe\u5728HORIZON\u8a66\u9a13\u3067\u691c\u8a3c\u304c\u9032\u3081\u3089\u308c\u3066\u3044\u308b\u3002<\/span><\/p>\n

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\u53c2\u8003\u6587\u732e<\/strong><\/p>\n

    \n
  1. Fruchart JC, Sacks F, Hermans MP, et al. The Residual Risk Reduction Initiative: a call to action to reduce residual vascular risk in patients with dyslipidemia. Am J Cardiol 2008;102(10 Suppl):1K-34K.<\/span>
    2.<\/span>\u00a0Fruchart JC, Davignon J, Hermans MP, et al. Residual macrovascular risk in 2013: what have we learned? Cardiovasc Diabetol 2014;13:26.<\/span>
    3.<\/span>\u00a0Patel KV, Pandey A, de Lemos JA. Conceptual framework for addressing residual atherosclerotic cardiovascular disease risk in the era of precision medicine. Circulation 2018;137:2551\u20133.<\/span>
    4.<\/span>\u00a0Halcox JP, Banegas JR, Roy C, et al. Prevalence and treatment of atherogenic dyslipidemia in the primary prevention of cardiovascular disease in Europe: EURIKA, a cross-sectional observational study. BMC Cardiovasc Disord. 2017;17:160<\/span>
    5.<\/span>\u00a0Reiner \u017d, De Bacquer D, Kotseva K, et al. Treatment potential for dyslipidaemia management in patients with coronary heart disease across Europe: findings from the EUROASPIRE III survey. Atherosclerosis. 2013;231:300\u20137<\/span>
    6.<\/span>\u00a0ACCORD Study Group, Ginsberg HN, Elam MB, Lovato LC, et al. Effects of combination lipid therapy in type 2 diabetes mellitus. N Eng J Med. 2010;362:1563\u201374.<\/span>
    7.<\/span>\u00a0Mach F, Baigent C, Catapano AL, et al. 2019 ESC\/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J 2020;41:111-88.<\/span>
    8.<\/span>\u00a0Nordestgaard BG, Langlois MR, Langsted A, et al. Quantifying atherogenic lipoproteins for lipid-lowering strategies: Consensus-based recommendations from EAS and EFLM. Atherosclerosis 2020;294:46-61.<\/span>
    9.<\/span>\u00a0Sandesara PB, Virani SS, Fazio S, Shapiro MD. The forgotten lipids: triglycerides, remnant cholesterol, and atherosclerotic cardiovascular disease risk. Endocr Rev 2019;40:537-57.<\/span>
    10.<\/span>\u00a0Nordestgaard BG. Triglyceride-rich lipoproteins and atherosclerotic cardiovascular disease: new insights from epidemiology, genetics, and biology. Circ Res 2016;118:547\u201363.<\/span>
    11.<\/span>\u00a0Raposeiras-Roubin S, Rossell\u00f3 X, Oliva B et al. Triglycerides and residual atherosclerotic risk. J Am Coll Cardiol 2021;22: 3031 \u2013 41.<\/span>
    12.<\/span>\u00a0Pradhan AD, Paynter NP, Everett BM, et al. Rationale and design of the Pemafibrate to Reduce Cardiovascular Outcomes by Reducing Triglycerides in Patients with Diabetes (PROMINENT) study. Am Heart J 2018;206:80-93.<\/span>
    13.<\/span>\u00a0Klingenberg R, Aghlmandi S, Gencer B, et al. Residual inflammatory risk at 12 months after acute coronary syndromes is frequent and associated with combined adverse events. Atherosclerosis 2021;320:31-7.<\/span>
    14.<\/span>\u00a0Ridker PM, Everett BM, Thuren T, et al. Antiinflammatory therapy with canakinumab for atherosclerotic disease. N Engl J Med 2017;377:1119-31.<\/span>
    15.<\/span>\u00a0Anand SS, Bosch J, Eikelboom JW, et al. Rivaroxaban with or without aspirin in patients with stable peripheral or carotid artery disease: an international, randomised, double-blind, placebo-controlled trial. Lancet 2018;391:219\u201329.<\/span>
    16.<\/span>\u00a0Sacks FM, Hermans MP, Fioretto P, et al. Association between plasma triglycerides and high-density lipoprotein cholesterol and microvascular kidney disease and retinopathy in type 2 diabetes mellitus: a global case-control study in 13 countries. Circulation 2014;129:999-1008.<\/span>
    17.<\/span>\u00a0Tanwar VS, Reddy MA, Natarajan R. Emerging role of long non-coding RNAs in diabetic vascular complications. Front Endocrinol (Lausanne). 2021;12:665811.<\/span><\/li>\n<\/ol>\n

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