脂蛋白 (a) 和标准可修改心血管风险因素与发生心肌梗塞的关联:大众通用布里格姆Lp (a) 注册表
Arthur Shiyovich1,2, Adam N Berman1, Stephanie A Besser1
1Division of Cardiovascular Medicine, Department of Medicine Brigham and Women's Hospital, Harvard Medical School Boston MA.
Journal of the American Heart Association
|May 18, 2024
概括
高脂蛋白 (a) [Lp(a) ]水平显著增加急性心肌梗塞 (AMI) 的风险,即使在没有标准可修改风险因素的个体中也是如此. 这一发现强调了Lp (a) 作为心脏病发作风险的关键,独立预测因素.
科学领域:
- 心脏病学 心脏病学
- 脂质学 脂质学是指脂质学.
- 预防医学 预防医学
背景情况:
- 脂蛋白 (a) [Lp(a) ]是冠状动脉心脏病的公认预测因子.
- 针对升高的Lp(a) 的向疗法正在开发中.
- 高Lp(a) 与发生急性心肌梗塞 (AMI) 的标准可修改危险因子 (SMuRF) 之间的关联需要进一步评估.
研究的目的:
- 评估高Lp(a) 水平和SMuRFs之间的关系,在经历第一次AMI的患者中.
- 为了确定高Lp(a) 是否独立预测AMI风险.
主要方法:
- 美国大众军校布里格姆总部 (Brigham Lp) 登记处 (2000-2019年) 的回顾性分析.
- 纳入年龄≥18岁的Lp (a) 测量患者,但不包括患有严重功能障碍,恶性瘤或先前动脉样硬化心血管疾病的患者.
- 使用NLP,ICD代码和实验室数据识别AMI结果和共变量.
主要成果:
- 总共分析了6238名符合条件的患者.
- 高Lp (a) 与较高的AMI发病率显著相关,不论SMuRF的数量如何.
- 高Lp (a) 所带来的风险相当于有两个SMuRF,经调整后的危险比为2.9 (95%CI,2.0-4.3).
结论:
- 高Lp (a) 是在没有先前动脉样硬化心血管疾病的患者中首次AMI的独立风险因素.
- (a) 构成AMI的重大风险,无论SMuRF是否存在.
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