测量脂蛋白 (a) 用于预防心血管疾病 - 在谁和什么时候?
Peter E Thomas1,2,3, Signe Vedel-Krogh1,2,3, Børge G Nordestgaard1,2,3
1Department of Clinical Biochemistry.
建议在所有成年人中一次测量脂蛋白,以准确预测心血管风险. 本指南的更新反映了新的发现和即将推出的高脂蛋白治疗方法.
科学领域:
- 心血管医学 心血管医学
- 临床脂质学 临床脂质学
- 遗传学和精准医学 遗传学和精准医学
背景情况:
- 升高的脂蛋白 (Lp) 是动脉样硬化心血管疾病 (ASCVD) 和大动脉狭窄症 (AS) 的独立因果风险因素.
- 国际指导方针越来越多地推Lp(a) 测量,以提高心血管风险分层.
- 鉴于新型Lp降低疗法的出现,准确的风险评估至关重要.
研究的目的:
- 总结当前关于脂蛋白的心血管指南建议.
- 突出最近的发现,支持在成年人中普遍测量Lp.
- 为了强调Lp的临床实用性,a) 对风险分层进行测试.
主要方法:
- 审查主要的国际心血管指南.
- 最近关于脂蛋白和心血管风险的研究综合.
- 对通用Lp (a) 测量的影响分析.
主要成果:
- 国际指导方针现在建议对所有成年人进行一次性脂蛋白测量.
- 脂蛋白 (a) 测试对不同人群的风险预测具有意义,不论年龄,性别,并发症或种族.
- 降脂蛋白疗法正在接近临床可用性,预计在2025年获得第三阶段试验结果.
结论:
- 常规Lp(a) 测量是个性化心血管风险预测的关键策略.
- 针对Lp (a) 的新兴疗法有望减少心血管事件.
- 该指南提倡将Lp (a) 值纳入常规临床实践.
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