20 / 10 / 15
关于“alirocumab与急性冠脉综合征后的心血管结局”的翻译学习，学习内容记录于此。
旧文重发，时间为2019-03-15
背景
BACKGROUND
急性冠脉综合征患者发生复发性缺血性心血管事件的风险较高。
Patients who have had an acute coronary syndrome are at high risk for recurrent ischemic cardiovascular events.
笔记：
A at high risk for B A出现B的风险较高
recurrent ischemic cardiovascular event 复发性缺血性心血管事件
我们试图确定在接受高强度他汀类药物治疗的患者中，alirocumab（前蛋白转化酶枯草溶菌素-9 [PCSK9]的人单克隆抗体）是否会改善急性冠脉综合征后的心血管结局。
We sought to determine whether alirocumab, a human monoclonal antibody to proprotein convertase subtilisin–kexin type 9 (PCSK9), would improve cardiovascular outcomes after an acute coronary syndrome in patients receiving high-intensity statin therapy.
笔记：
a human monoclonal antibody to X X的人单克隆抗体
acute coronary syndrome 急性冠脉综合征
high-intensity statin therapy 高强度他汀类药物治疗
句子逻辑：插入语；动名词做补充说明
方法
Methods
我们在1～12个月前罹患急性冠脉综合征，低密度脂蛋白（LDL）胆固醇水平至少为70 mg/dL（1.8 mmol/L）、非高密度脂蛋白胆固醇水平至少为100 mg/dL（2.6 mmol/L）或载脂蛋白B水平至少为80 mg/dL，并且正在接受高强度剂量或最大耐受剂量他汀类药物治疗的18,924例患者中，开展了一项多中心、随机、双盲、安慰剂对照试验。
We conducted a multicenter, randomized, double-blind, placebo-controlled trial involving 18,924 patients who had an acute coronary syndrome 1 to 12 months earlier, had a low-density lipoprotein (LDL) cholesterol level of at least 70 mg per deciliter (1.8 mmol per liter), a non−high-density lipoprotein cholesterol level of at least 100 mg per deciliter (2.6 mmol per liter), or an apolipoprotein B level of at least 80 mg per deciliter, and were receiving statin therapy at a high-intensity dose or at the maximum tolerated dose.
笔记：
level of at least 70 mg per deciliter 至少为70 mg/dL
1.8 mmol per liter 1.8 mmol/L
maximum tolerated dose MTD
句子逻辑：先说最重要的“开展了一项多中心、随机、双盲、安慰剂对照试验。”
中文表达：罹患
患者被随机分组，接受75 mg剂量的alirocumab（9,462例患者）或匹配安慰剂（9,462例患者）每2周1次皮下给药。
Patients were randomly assigned to receive alirocumab subcutaneously at a dose of 75 mg (9462 patients) or matching placebo (9462 patients) every 2 weeks.
笔记：
subcutaneously
at a dose of
matching placebo
在设盲的情况下调整alirocumab剂量，以25～50 mg/dL（0.6～1.3 mmol/L）的LDL胆固醇水平为目标。
The dose of alirocumab was adjusted under blinded conditions to target an LDL cholesterol level of 25 to 50 mg per deciliter (0.6 to 1.3 mmol per liter).
笔记：
adjusted under blinded conditions 在设盲的情况下调整
to target target作动词
level of 25 to 50 mg level of A to B (without "from")
主要终点是由冠心病死亡、非致死性心肌梗死、致死性或非致死性缺血性卒中或者需要住院的不稳定型心绞痛构成的复合终点。
The primary end point was a composite of death from coronary heart disease, nonfatal myocardial infarction, fatal or nonfatal ischemic stroke, or unstable angina requiring hospitalization.
笔记：
death from coronary heart disease 冠心病死亡
nonfatal myocardial infarction 非致死性心肌梗死
fatal or nonfatal ischemic stroke 致死性或非致死性缺血性卒中
unstable angina requiring hospitalization 需要住院的不稳定型心绞痛
The primary end point was a composite of ··· 主要终点是由······构成的复合终点
结果
RESULTS
中位随访持续时间为2.8年。
The median duration of follow-up was 2.8 years.
笔记：
随访没有再加一个visit
alirocumab组903例患者（9.5%）和安慰剂组1,052例患者（11.1%）发生了复合主要终点事件（风险比，0.85；95%置信区间[CI]，0.78～0.93；P＜0.001）。
A composite primary end-point event occurred in 903 patients (9.5%) in the alirocumab group and in 1052 patients (11.1%) in the placebo group (hazard ratio, 0.85; 95% confidence interval [CI], 0.78 to 0.93; P<0.001).
笔记：
composite primary end-point event 复合主要终点事件
共有alirocumab组334例患者（3.5%）和安慰剂组392例患者（4.1%）死亡（风险比，0.85；95% CI，0.73～0.98）。
A total of 334 patients (3.5%) in the alirocumab group and 392 patients (4.1%) in the placebo group died (hazard ratio, 0.85; 95% CI, 0.73 to 0.98).
在基线LDL胆固醇水平≥100 mg/dL的患者中，alirocumab在复合主要终点方面的绝对获益大于基线水平较低的患者。
The absolute benefit of alirocumab with respect to the composite primary end point was greater among patients who had a baseline LDL cholesterol level of 100 mg or more per deciliter than among patients who had a lower baseline level.
笔记：
absolute benefit 绝对获益
with respect to 在······方面
除了局部注射部位反应（alirocumab组3.8% *vs.*安慰剂组2.1%）之外，两组的不良事件发生率相似。
The incidence of adverse events was similar in the two groups, with the exception of local injection-site reactions (3.8% in the alirocumab group vs. 2.1% in the placebo group).
结论
CONCLUSIONS
在既往患急性冠脉综合征并且正在接受高强度他汀类药物治疗的患者中，接受alirocumab治疗患者的复发性缺血性心血管事件风险低于接受安慰剂治疗的患者（由赛诺菲和再生元制药[Regeneron Pharmaceuticals]资助；ODYSSEY OUTCOMES在ClinicalTrials.gov注册号为NCT01663402）。
Among patients who had a previous acute coronary syndrome and who were receiving high-intensity statin therapy, the risk of recurrent ischemic cardiovascular events was lower among those who received alirocumab than among those who received placebo. (Funded by Sanofi and Regeneron Pharmaceuticals; ODYSSEY OUTCOMES ClinicalTrials.gov number, NCT01663402 .)
笔记：
时态很有意思。
虽然目前有循证治疗方法，但急性冠脉综合征患者发生复发性缺血性心血管事件的风险仍然较高1,2 。
Despite the availability of current evidence-based treatments, patients who have had an acute coronary syndrome remain at high risk for recurrent ischemic cardiovascular events.1,2
笔记：
the availability of
这种残留风险部分是由于低密度脂蛋白（LDL）胆固醇和其他致动脉粥样硬化脂蛋白水平升高引起。
This residual risk is attributable in part to elevated levels of low-density lipoprotein (LDL) cholesterol and other atherogenic lipoproteins.
笔记：
be attributable to 是由于
之前的临床试验已经表明，接受他汀类药物治疗以降低LDL胆固醇水平的患者，其风险低于接受安慰剂治疗的患者3 ，接受高强度他汀类药物治疗的患者，其风险低于接受中等强度他汀类药物治疗的患者4 ，并且接受他汀类药物+依折麦布治疗的患者，其风险低于接受他汀类药物单独治疗的患者5 。
Previous clinical trials have shown that the risk is lower among patients who receive statin therapy to lower the LDL cholesterol level than among those who receive placebo,3 among patients who receive high-intensity statins than among those who receive moderateintensity statins,4 and among patients who receive ezetimibe added to statin therapy than among those who receive a statin alone.5
笔记：
比较级经典用法
PCSK9能够促进LDL受体降解，从而减少循环系统内LDL的清除6 。
Proprotein convertase subtilisin–kexin type 9 (PCSK9) promotes degradation of LDL receptors, thereby diminishing the clearance of LDL from the circulation.6
笔记：
动名词经典用法
研究已经表明，导致PCSK9功能获得或丧失的突变会分别导致较高或较低的LDL胆固醇水平，这又与相应较高7 或较低6 的新发冠心病风险相关。
Studies have shown that mutations conveying gain or loss of function of PCSK9 result in a higher or lower level of LDL cholesterol, respectively, which in turn is associated with a corresponding higher7 or lower6 risk of incident coronary heart disease.
这些发现促使我们开发出PCSK9的单克隆抗体，当单独给药或与他汀类药物联合用药时，PCSK9单克隆抗体能够显著降低LDL胆固醇水平8-12 。
These findings have led to the development of monoclonal antibodies to PCSK9 that produce substantial reductions in LDL cholesterol **when administered alone or with a statin.**8-12
笔记：
不重要的部分，在英文中的处理值得注意
“PCSK9单克隆抗体”的处理值得学习
在此类药物中，据报告有两种能够降低患稳定型动脉粥样硬化疾病或具有高心血管风险，并且虽然接受他汀类药物治疗，但致动脉粥样硬化脂蛋白水平仍然升高的患者的缺血性心血管事件风险11,13 ，其中一种药物仅在基线LDL胆固醇水平至少为100 mg/dL（2.6 mmol/L）的患者中显示出获益12 。
Two of these agents were reported to reduce the risk of ischemic cardiovascular events in patients who had stable atherosclerotic disease or high cardiovascular risk and an elevated level of atherogenic lipoproteins despite statin treatment,11,13 with one agent showing benefit only among patients who had a baseline LDL cholesterol level of at least 100 mg per deciliter (2.6 mmol per liter).12
笔记：
With 结构
迄今，PCSK9抗体在急性冠脉综合征后降低心血管风险的潜在作用仍然未确定。
To date, the potential for a PCSK9 antibody to reduce cardiovascular risk after an acute coronary syndrome remains undetermined.
在ODYSSEY OUTCOMES试验中，我们检验了以下假设，在之前1～12个月内罹患急性冠脉综合征，并且虽然接受高强度剂量或最大耐受剂量的他汀类药物治疗，但致动脉粥样硬化脂蛋白水平仍超过规定阈值的患者中，alirocumab（PCSK9的一种完全人单克隆抗体13-15 ）治疗与安慰剂相比能够获得较低的复发性缺血性心血管事件风险。
In the ODYSSEY OUTCOMES trial, we tested the hypothesis that treatment with alirocumab, a fully human monoclonal antibody to PCSK9,13-15 would result in a lower risk of recurrent ischemic cardiovascular events than placebo among patients who had an acute coronary syndrome within the preceding 1 to 12 months and who have levels of atherogenic lipoproteins that exceed specified thresholds despite statin therapy at a high-intensity dose or at the maximum tolerated dose.
笔记：
preceding
（英文为NEJM原文，中文为NEJM医学前沿官方译文。）
作者简介：
四川外国语大学成都学院翻译系英语（翻译方向）专业
重庆医科大学外国语学院英语笔译专业
英语专业八级
人事部三级、二级英语笔译资格证书持证
人事部三级英语口译资格证书持证
文思海辉技术有限公司 QQ音乐歌词翻译（全职，2014年年度优秀新人）
重庆润泽医药有限公司 医学翻译实习生（翻译、数据整理）
成都创思立信信息技术有限公司 医学翻译实习生（翻译、校对）；医学翻译、校对、导师、项目经理
曾多次为凤凰科技，解放军某高校，成都某化妆品公司提供翻译服务
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