莱登因子与随后的动脉血栓事件的关联:GENIUS-CHD对个人参与者数据的研究
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
概括
在患有冠心病 (CHD) 的患者中,V Leiden因子不会增加动脉血事件的风险. 不建议在这个群体中进行常规基因测试来分类风险.
科学领域:
- 心血管遗传学
- 血栓形成和血液静止
- 流行病学
背景情况:
- 对于已经确诊的冠状动脉疾病 (CHD) 患者的V Leiden因子作用的研究有限.
- 凝血因子,包括VLeiden因子,可能会影响动脉样斑块的血栓形成.
- 假设:V莱登因子是心脏病患者发生动脉血栓事件的重要危险因素.
研究的目的:
- 在已确诊的冠状动脉疾病患者中调查V莱登因子和动脉血事件之间的关联.
- 确定V莱登因子是否可以改善这一高危人群中心血管事件的风险分层.
主要方法:
- 25项前性研究的个人层面的元分析 (GENIUS-CHD联盟).
- 包括69681名已确诊的冠状动脉疾病的参与者,评估了因子V莱登状态.
- 用于评估初级 (MI,心脏病死亡) 和二次结局的Cox回归和固定效应元分析.
主要成果:
- 莱登V因子与心肌梗塞或心脏病死亡风险的增加无关 (HR1. 03,95% CI0. 92-1. 16).
- 基于心血管风险因素的亚组分析没有发现显著差异.
- 二次结局,包括中风和死亡率,也没有与V莱登因子相关.
结论:
- 在已确诊的冠状动脉疾病患者中,V Leiden因子不会增加后续动脉血栓事件或死亡的风险.
- 常规评估V莱登因子不太可能在该人群中增加动脉血风险分层.
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