脂蛋白a - Lp (a) 在
1Director and Head of Cardiology, Fortis Flt Lt Rajan Dhall Hospital New Delhi, 11-0070, India.
Indian heart journal
|December 31, 2023
概括
升高的脂蛋白 (Lp) 是动脉样硬化心血管疾病 (ASCVD) 的关键遗传风险因素. 建议测量Lp (a),特别是在有心脏病家族史的情况下,以指导风险管理.
科学领域:
- 心脏病学 心脏病学
- 遗传学 遗传学 是一个
- 预防医学 预防医学
背景情况:
- 脂蛋白 (Lp) 是动脉样硬化心血管疾病 (ASCVD) 的独立,基因决定的风险因素.
- 大约20%的全球人口和25%的印度人有升高的Lp (a) 水平 (>50 mg/dL或>125 nmol/L).
- 升高的Lp (a) 与心肌梗塞,中风,心力衰竭和通过促炎和促动脉动脉的机制增加的死亡风险有关.
研究的目的:
- 要突出脂蛋白 (Lp) 作为动脉样硬化心血管疾病 (ASCVD) 的因果风险因素的重要性.
- 强调升高的Lp (a) 的患病率及其与心血管事件和死亡率的关联.
- 讨论目前对Lp (a) 测量,级联测试和新兴治疗策略的建议.
主要方法:
- 流行病学,全基因组关联和门德尔随机化研究的综述.
- 在各种临床环境和人群中分析Lp(a) 水平,包括最近印度对冠状动脉疾病 (CAD) 患者的研究.
- 评估新兴的Lp (a) 降低疗法,如PCSK9抑制剂,Inclisiran和Pelacarsen.
主要成果:
- 流行病学和遗传学研究证实Lp (a) 是一种因果性ASCVD风险因素.
- 升高的Lp (a) 水平与心肌梗塞,中风和死亡率的增加有关.
- 最近的一项印度研究发现,在CAD患者中,升高的Lp (a) 与严重血管学疾病相关,特别是在患有家族性高胆固醇血症 (FH) 的年轻患者中.
结论:
- 脂蛋白 (Lp) 是动脉样硬化心血管疾病 (ASCVD) 的关键性,遗传性风险因素,需要终身监测.
- 建议一生至少进行一次Lp (a) 的测量,对具有高Lp (a) 或早发ASCVD家族病史的个人进行级联测试.
- 虽然综合性风险因素管理至关重要,但像Pelacarsen这样的新型Lp (a) 降低疗法显示出降低心血管风险的巨大潜力.
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