脂蛋白 (a):ASCVD风险因子拼图中的一个重要组成部分,跨越不同人群的风险因子
Nicole Ciffone1, Catherine J McNeal2, Mary P McGowan3,4
1Arizona Center for Advanced Lipidology, 3925 E Fort Lowell Rd, Tucson, AZ 85712, USA.
概括
升高的脂蛋白a (Lp[a]) 是动脉样硬化心血管疾病 (ASCVD) 的遗传风险因素. Lp[a]测试可以识别高风险的个体,从而实现个性化的心血管疾病管理和家庭查.
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:
- 高脂蛋白a (Lp[a]) 是动脉样硬化心血管疾病 (ASCVD) 的重要遗传风险因素,影响全球约14亿人.
- Lp[a]水平是基因决定的,并在一生中保持稳定,因此,一次不禁食的血液检测足以进行终身风险评估.
- 尽管具有临床效用,但常规Lp[a]测试在临床实践中未得到充分利用.
研究的目的:
- 审查脂蛋白测试在识别和管理心血管疾病风险方面的好处.
- 概述克服常规Lp测试障碍的策略,如可访问性和意识.
- 强调Lp (a) 测试作为心血管风险评估的基本组成部分的重要性.
主要方法:
- 本综述综合了目前关于Lp(a) 测试的文献,其临床含义以及实际实施的挑战.
- 它研究了Lp (a) 在风险分层中的作用及其对治疗决策的影响,包括对他类药物治疗的反应.
- 该审查讨论了亲属的级联查,以及改善测试采用的策略.
主要成果:
- Lp (a) 测试允许重新分类ASCVD风险,指导高水平个体进行更密集的管理.
- 识别升高的Lp (a) 可以帮助预测哪些患者可能对他类药物治疗没有最佳反应.
- 对家庭成员的级联查可以揭示受影响个体亲属的遗传心血管风险.
结论:
- 脂蛋白 (a) 检测对于识别具有ASCVD遗传风险增加的个体至关重要.
- 常规的Lp (a) 评估应整合到初级和专科护理中,以优化心血管风险管理.
- 消除对测试访问和意识的障碍对于广泛采用和改善患者结果至关重要.
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