严重家族高胆固醇血清症状态对动脉样硬化风险的影响
Hayato Tada1, Atsushi Nohara2, Soichiro Usui3
1Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan. ht240z@sa3.so-net.ne.jp.
Scientific reports
|November 13, 2023
概括
患有严重家族性高胆固醇血症 (FH) 的患者面临显著更高的重大心脏不良事件 (MACE) 风险. 这种分类有助于识别需要加强管理以预防动脉样硬化疾病的高风险个体.
科学领域:
- 心脏病学 心脏病学
- 遗传学 是一个遗传学.
- 公共卫生 公共卫生
背景情况:
- 家族性高胆固醇血症 (FH) 是一种遗传性疾病,其特征是极高的低密度脂蛋白胆固醇 (LDL-C) 水平.
- 心血管事件的风险在FH患者之间有很大的差异,尽管终身高LDL-C暴露.
- 国际动脉样硬化学会 (IAS) 定义了严重的FH状态,但其对事件风险的临床影响需要进一步研究.
研究的目的:
- 调查国际标准定义的严重FH状态对重大心脏不良事件 (MACE) 发生率的影响.
- 在初级和二级预防设置中,在严重的FH和非严重的FH患者之间比较MACE率.
主要方法:
- 对1050名入住金沢大学医院的FH患者 (2000-2020年) 的回顾性审查.
- 根据IAS标准将患者分为严重的FH (51.9%) 和非严重的FH组.
- 计算每 1000 人/年的 MACE 率 (心血管死亡率, ACS,需要再血管化的缺血性心脏病).
- 使用考克斯比例模型确定的危险比率.
主要成果:
- 在12.6年的中位数随访期间,共记录了171个MACE.
- 严重的FH与MACE的更高风险显著相关 (HR=6.48,P <1.2 × 10−5).
- 在初级预防中,每1000人年发生事件率为严重FH的15.6,而非严重FH的0.0,在二级预防中,严重FH的32.3,非严重FH的2.0.
结论:
- 根据IAS标准定义的严重FH状态是MACEs的强有力的独立预测指标.
- 患有严重FH的患者表现出大大增加动脉样硬化事件的风险,无论是初级或二级预防.
- 这种简单的分类有助于识别高风险的FH个体,他们可能会从更积极的治疗策略中受益.
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