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Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...
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使用遗传风险评分预测动脉样硬化病患者的Evolocumab治疗的益处:FOURIER试验的结果

Nicholas A Marston1, Frederick K Kamanu1, Francesco Nordio1

  • 1TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (N.A.M., F.K.K., F.N., Y.G., R.P.G., M.S.S., C.T.R.).

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概括

基因风险评分预测心血管疾病风险,并确定受益于PCSK9 (proprotein convertase subtilisin/ kexin type 9) 抑制的患者. 高遗传风险表明,埃沃洛库马布治疗的益处更大.

关键词:
人类PCSK9蛋白心血管疾病其他药物遗传学危险因素

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科学领域:

  • 心血管医学
  • 遗传学
  • 药理学

背景情况:

  • 基因风险评分在预测心血管疾病 (CVD) 风险和治疗益处方面的作用尚不清楚.
  • 已确定的心血管疾病患者的风险分层和个性化治疗需要进一步调查.

研究的目的:

  • 评估遗传风险评分预测已确诊动脉样性心血管疾病 (ASCVD) 患者风险的能力.
  • 确定基因风险评分是否能确定受益于PCSK9抑制治疗的个体.

主要方法:

  • 对14298名ASCVD患者的FOURIER试验进行分析.
  • 使用27个单核酸多态遗传风险评分将患者分为低,中,高遗传风险组.
  • 风险因素包括糖尿病,高血压,高LDL- C和吸烟;多种风险因素定义了高临床风险.

主要成果:

  • 基因风险评分独立预测主要冠状动脉和血管事件 (P<0. 005).
  • 高遗传风险与严重冠状动脉事件的风险增加了1. 65倍.
  • 无论临床风险如何,具有高遗传风险的患者表现出埃沃洛库马布的最大相对和绝对益处 (31%的RR降低,4. 0%的ARR).

结论:

  • 没有高遗传风险或多种临床风险因素的患者的发病率低,而evolocumab的益处也很小.
  • 高遗传风险确定了具有高事件率的患者,他们从evolocumab治疗中获得了实质性的益处.
  • 在ASCVD患者中,基因风险分层可以个性化PCSK9抑制剂治疗决策.