心血管疾患患者のLp (a) 検査と管理に関する医師の見解:INTERASPIREから世界保健機関 (WHO) の5つの地域における7カ国のインタビュー
Jaimini Cegla1,2, Catriona Jennings3, Eanna Kenny3
1Lipids and Cardiovascular Risk Service, Hammersmith Hospital, Imperial College Healthcare NHS Trust, Du Cane Road, London W12 0HS, UK.
European journal of preventive cardiology
|August 29, 2025
まとめ
血管新生性動脈疾患 (ASCVD) のリスクに対するリポプロテイン (Lp) 検査に関する医師の知識とアクセスは,世界的に大きく異なります. 患者さんの管理とケアを改善するには ターゲットに絞った教育が不可欠です
科学分野:
- 心臓病科
- 遺伝学
- 公衆衛生
背景:
- 脂質タンパク質 (Lp) は,動脈硬化性心血管疾患 (ASCVD) の遺伝的に決定された独立リスク因子である.
- INTERASPIRE研究は,世界保健機関 (WHO) の6つの地域における14カ国の二次予防を調査した国際コホート研究です.
研究 の 目的:
- Lp (a) 検査とASCVDの二次予防に関する医師の知識と見解を調査する.
- 臨床実務におけるLp (a) 検査の障壁と促進要因を特定する.
主な方法:
- 7か国 (中国,コロンビア,ケニア,ナイジェリア,マレーシア,ポーランド,アラブ首長国連邦) の医師を電話でインタビューした副研究.
- 特別に開発されたアンケートを使用して,ASCVDの知識とLp (a) テストの実践を評価しました.
- 心臓病専門医,内分泌医,脂質専門医など 245 人の医師をインタビューしました
主要な成果:
- Lp (a) 測定へのアクセスは国によって異なり,医師の43%しかアクセスできず,定期的に測定する医師の50%しかアクセスできませんでした.
- 医師は,早発の冠動脈疾患,再発,および家族歴のLp (a) 検査を最も頻繁に要求しました.
- 高いLp (a) レベルの解釈は,医師の32%が定義に自信がないか,または認識していないと,著しい異質性を示した.
結論:
- 患者や親戚に対するLp (a) 検査の利点は広く認められているが,その利用と一貫した適用は一貫していない.
- 医者の間でLp (a) 値上昇の定義と解釈には大きな差異がある.
- 臨床的意思決定を標準化し,ASCVDのリスク管理を改善するために,Lp (a) に関する医師教育の強化が不可欠です.
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