フォクターV・ライデンの関連性とその後のアテロロンボティックイベント:個々の参加者のデータに関するGENIUS-CHD研究
Bakhtawar K Mahmoodi1,2, Vinicius Tragante3, Marcus E Kleber4
1St. Antonius Hospital, Department of Cardiology, Nieuwegein, the Netherlands (B.K.M., T.O.B., J.M.t.B.).
Circulation
|July 14, 2020
まとめ
冠動脈疾患 (CHD) の患者では,V Leiden因子による動脈血栓症のリスクは増加しません. この集団におけるリスクの階層化のために,この因子に対する通常の遺伝子検査は推奨されません.
科学分野:
- 心血管遺伝学
- 血栓形成と血液静止
- 流行病学について
背景:
- 既定の冠動脈疾患 (CHD) の患者におけるファクターV・ライデンの作用に関する研究は限られている.
- 動脈硬化プラークの血栓形成に影響を与える可能性があります.
- 仮説: V レイデン因子は,心臓病患者の動脈血栓症の重要な危険因子である.
研究 の 目的:
- 確立されたCHDの患者におけるVレイドン因子とアテロロンボティックイベントの関連性を調査する.
- この高リスクグループにおける心臓血管疾患のリスクの階層化を改善できるかどうかを判断する.
主な方法:
- 25件の見通し研究 (GENIUS-CHDコンソーシアム) の個人レベルのメタ解析
- 確定したCHDの69,681人の参加者を含め,ファクターVライデン状態を評価した.
- コックス回帰と固定効果メタアナリシスは,プライマリ (MI,CHD死亡) と二次的なアウトカムを評価するために使用されました.
主要な成果:
- Vレイドン因子は心筋梗塞や心血管疾患による死亡リスクの増加と関連しませんでした (HR1. 03, 95% CI 0. 92-1. 16).
- 心血管リスク因子に基づくサブグループ分析では,有意な差異は認められなかった.
- 脳卒中と死亡率を含む二次的アウトカムも,ファクターV・ライデンとの関連性を示さなかった.
結論:
- 確定したCHDの患者では,その後の動脈血栓症の発生や死亡のリスクを高めません.
- レーデンV因子の定期的な評価は,この集団におけるアテロロンボティックリスクの階層化を高める可能性は低い.
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