人口ベースの心血管リスクの階層化のための非HDLコレステロールの適用:多国籍心血管リスクコンソーシアムの結果
Fabian J Brunner1, Christoph Waldeyer1, Francisco Ojeda1
1University Heart & Vascular Center Hamburg, Department of Cardiology, Hamburg, Germany.
Lancet (London, England)
|December 8, 2019
まとめ
高度な非HDLコレステロールは,長期的な心血管疾患のリスクを大幅に高めます. 早期の脂質低下治療は,このリスクを大幅に軽減し,第一予防戦略に役立ちます.
科学分野:
- 心臓病科
- 公衆衛生
- バイオ統計学
背景:
- 血脂値と心血管疾患 (CVD) の発生率,および脂質低下療法の影響は,さらに明確にする必要があります.
- 非高密度脂質 (非HDL) のコレステロール濃度の全スペクトルの調査は,CVDのリスクを理解するために不可欠です.
研究 の 目的:
- 様々な非HDLコレステロール値に関連した心血管疾患のリスクを評価する.
- 長期のCVDの発生確率と脂質低下治療によるリスク減少を推定するためのツールを開発する.
主な方法:
- 19カ国の多国籍心血管リスクコンソーシアムのデータを活用した.
- HDL以外のコレステロールのカテゴリーに対する欧州ガイドラインの値を用いて,性別特有の多変量分析を行った.
- 75歳までにCVDのリスク予測ツールを開発し,検証し,非HDLコレステロールの50%の減少をモデル化しました.
主要な成果:
- 男性と女性の両方において,非HDLコレステロールのカテゴリーの増加とともに,徐々に高い30年CVDイベント率が観察されました.
- 非HDLコレステロール濃度の上昇は,心血管疾患のリスクの増加と有意な関連性を示した (HRは1.1から2. 3であった).
- 開発されたツールは,CVDイベントの確率を予測し,リスク削減をモデル化するのに高い精度を示しました.
結論:
- 血液中の非HDLコレステロール濃度は,慢性動脈硬化性心血管疾患のリスクと強く関連しています.
- 個々のリスク評価と早期の脂質低下介入の利点を示すための簡単なツールが提供されています.
- この発見は,初等心血管疾患予防戦略に関する医師と患者のコミュニケーションを支えるものです.
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