リポプロテイン (a) と心筋梗塞のリスクに関する前向きな研究
P M Ridker1, C H Hennekens, M J Stampfer
1Department of Medicine, Brigham and Women's Hospital, Boston, MA 02215-1204.
JAMA
|November 10, 1993
まとめ
増加したリポプロテイン (a) [Lp (a) ]レベルは,中年男性における心筋梗塞のリスクを増加させなかった. この研究は,Lp (a) が,この集団における心血管リスクの信頼性の高いスクリーニングツールではないことを示唆しています.
科学分野:
- 心血管医学 心血管医学
- リピドロジーは,脂質学です.
- 予防性心臓病学 予防性心臓病学
背景:
- リポプロテイン (Lp) は,新興の心血管疾患の危険因子である.
- 以前の研究では,Lp(a) と心筋梗塞 (MI) の関連性について,矛盾する結果が得られた.
研究 の 目的:
- 増加したリポプロテイン (a) レベルと心筋梗塞 (MI) の発生リスクとの関連を前向きに評価する.
主な方法:
- 医者の健康研究の中で,内蔵された症例対照研究が行われました.
- 前回の心筋梗塞や脳卒中のない男性医師14,916人が,ベースラインの血サンプルを提供した.
- 追跡期間は平均60.2ヶ月で,Lp (a) レベルは296人のMI症例とマッチングされた対照群で分析されました.
主要な成果:
- MI症例と対照群の間でLp (a) 値の有意な差は認められなかった (中位は103.0 mg/L vs 102.5 mg/L,P = .73).
- 年齢,喫煙,その他の心血管リスク要因をコントロールした分析では,Lp(a) レベルとMIリスクとの間には関連性がないことが示されました (P for trend = .93).
- 様々なLp (a) カットオフレベルでは,値効果は認められませんでした.
結論:
- この前向きな研究では,リポプロテイン (a) レベルが,主に中年白人男性における将来の心筋梗塞のリスク増加と関連している証拠は見つかりませんでした.
- この調査結果は,この集団における心血管疾患のリスク評価のためのスクリーニングツールとしてLp (a) の使用を支持しません.
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