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与脂质相关的标记物和心血管疾病预测

, Emanuele Di Angelantonio, Pei Gao

|July 17, 2012

概括

评估新兴的脂质标记物,如阿波利波蛋白B/A-I,脂质蛋白(a) 和脂质蛋白相关的脂酶A2,在预测第一个心血管事件 (CVD) 中提供了轻微的改善. 这些标志物有助于重新分类潜在的他类药物治疗中等风险个体.

科学领域:

心血管疾病研究研究
脂质新陈代谢和生物标志物
预防性心脏病学预防性心脏病学

背景情况:

新型脂质相关标记物用于预测初始心血管事件的临床实用性仍在研究中.
现有的风险预测模型通常依赖于传统的脂质样本,如总胆固醇和HDL-C.

研究的目的:

评估是否结合阿波利波蛋白B和A-I,脂蛋白a或脂蛋白相关的脂酶A2可以提高心血管疾病 (CVD) 风险预测.
评估这些新兴标记物的增量值,当添加到标准脂质测量 (总胆固醇,HDL-C) 时.

主要方法:

来自37个潜在队列的个人参与者数据的分析,包括165,544名没有基线CVD的个人.
包括多达15,126个事件心血管疾病结局 (冠心病和中风),平均随访时间为10.4年.
评估模式歧视和重新分类参与者在低,中等和高10年心血管疾病风险层.

主要成果:

添加阿波利波蛋白B/A-I,脂蛋白(a) 或与脂蛋白相关的脂酶A2表明在心血管疾病结果歧视 (C指数变化) 中具有统计学意义的改善.
对于大多数标志物来说,当它们被添加到传统风险分数中时,净重新分类改进是适度的 (<1%).
使用这些标记物的测试确定了中等风险个体的小但显著的百分比,这些人将被重新归类为高风险类别,可能需要治疗他类药物.

结论:

将阿波利波蛋白B和A-I,脂蛋白 (a) 或与脂蛋白相关的脂酶A2质量纳入风险预测模型,可以轻微提高预测心血管疾病风险.
这些新兴的脂质标记物为完善心血管疾病风险评估在没有确定的心血管疾病的个体提供了增量价值.
这些发现表明在指导治疗决策方面具有潜在的实用性,特别是在最初被归类为中等风险的个人中.

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