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在美国成年人中,阿司匹林用于初级预防,有或没有升高的脂蛋白水平 (a)
Alexander C Razavi1, LaTonia C Richardson2, Fátima Coronado2
1Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA, United States.
American journal of preventive cardiology
|May 14, 2024
概括
定期使用阿司匹林显著降低了动脉样硬化心血管疾病 (ASCVD) 死亡率,在患有高脂蛋白 (Lp) [Lp) ]的人群中. 这一发现对ASCVD初级预防策略有影响.
科学领域:
- 心血管医学 心血管医学
- 流行病学 流行病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 脂蛋白 (Lp) 是动脉样硬化心血管疾病 (ASCVD) 的关键危险因素,有助于动脉样硬化和血栓形成.
- 了解Lp(a) 水平与阿司匹林治疗的益处之间的相互作用对于个性化的心血管风险管理至关重要.
研究的目的:
- 调查定期使用阿司匹林与ASCVD死亡率之间的关联,在一个按脂蛋白[Lp[a]水平分层的美国人口中.
- 要确定升高的Lp (a) 是否会改变阿司匹林对ASCVD死亡率的影响.
主要方法:
- 分析了具有全国代表性的美国队列 (NHANES III,1988-1994) 与相关的死亡率数据.
- 参与者 (年龄在40-70岁之间,没有临床ASCVD) 根据Lp (a) 水平 (≥50 mg/dL与<50 mg/dL) 和定期使用阿司匹林 (≥30次/月) 分类.
- 权重考克斯比例危险回归模型被用于评估ASCVD死亡率在26年的中位数随访期间.
主要成果:
- 在大约7300万美国成年人中,定期使用阿司匹林与患有升高Lp(a) (危险比率=0.48) 个体中ASCVD死亡风险降低了52%.
- 在没有升高Lp(a) (危险比率=1.01) 的个体中,定期使用阿司匹林和ASCVD死亡率之间没有明显的关联.
- 一个显著的相互作用 (p=0.001) 表明,阿司匹林对ASCVD死亡率的益处仅限于Lp升高的人.
结论:
- 定期使用阿司匹林表明,阿司匹林在患有高脂蛋白 (Lp) 和没有先前临床ASCVD的个体中对ASCVD死亡率有显著的保护作用.
- 这些发现表明,Lp(a) 状态可能是涉及阿司匹林的初级预防策略的重要考虑因素.
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