Research Progress on Residual Cardiovascular Risk

即便在当今心血管疾病(CVD)的预防和治疗手段较前已获得显著的改善的情况下(如他汀调脂治疗、抗血小板治疗、控制血压等)，大量患者在接受标准治疗后仍存在显著的残余心血管风险(Residual Cardiovascular Risk, RCR)，RCR指尽管患者已接受基于指南推荐的标准治疗，但仍存在难以通过现有手段进一步降低的“硬终点”风险(指无法完全消除如心肌梗死、卒中、心血管死亡等心血管事件)。其定义随着对脂质代谢、炎症反应、代谢综合征的深入理解逐步扩展，现已成为心血管风险管理的重要方向。这一概念强调现代医学干预的局限性，并提示需超越传统危险因素管理，关注尚未被充分靶向的病理生理机制。本文通过查阅对比国内外相关文献，就残余心血管风险的相关概念、病理生理机制、相关生物标志物、新兴研究进展及干预策略进行综述，旨在为优化风险管理提供参考。Even with significant advancements in the prevention and treatment of cardiovascular disease (CVD) today—such as statin-based lipid management, antiplatelet therapy, and blood pressure control—a substantial number of patients still face considerable residual cardiovascular risk (RCR) despite receiving standard guideline-recommended therapies. RCR refers to the persistent risk of “hard endpoints” (such as myocardial infarction, stroke, and cardiovascular death) that remains difficult to further reduce with current interventions, even after optimal guideline-directed treatment. The definition of RCR has evolved with deeper insights into lipid metabolism, inflammatory responses, and metabolic syndrome, and it has now become a key focus in cardiovascular risk management. This concept highlights the limitations of modern medical interventions and underscores the need to look beyond traditional risk factor management by addressing underlying pathophysiological mechanisms that remain insufficiently targeted. By reviewing and comparing relevant domestic and international literature, this article provides a comprehensive overview of RCR, including its conceptual framework, pathophysiological mechanisms, associated biomarkers, emerging research advances, and potential intervention strategies. The aim is to offer insights for optimizing risk management approaches.