在现实世界中,对阿波脂蛋白B和脂蛋白 (a) 的检测率较低
Dana J Murdock1, Keran Moll1, Robert J Sanchez1
1Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA (Murdock, Moll, Sanchez, Gu, Fazio, Geba), Center for Academic Medicine, Department of Medicine/Division of Cardiovascular Medicine, Stanford University School of Medicine, Palo Alto, CA, USA (Rodriguez).
American journal of preventive cardiology
|September 16, 2024
概括
2019年,只有38%的美国保险成年人接受了脂质面板测试,不到1%的人接受了Apolipoprotein B (ApoB) 或脂质蛋白 (a) (Lp[a]) 的测试. 这些心血管疾病风险标志物未得到充分利用,尽管指南建议使用它们.
科学领域:
- 评估心血管疾病风险评估
- 临床脂质学 临床脂质学
- 医疗服务研究 医疗服务研究
背景情况:
- 阿波脂蛋白B (ApoB) 和脂蛋白 (a) (Lp[a]) 是已确定的心血管疾病 (CVD) 风险的预测因素.
- 目前的指导方针建议在标准脂质面板旁边进行ApoB和Lp (a) 测试,以进行全面的心血管疾病风险评估.
- 美国对ApoB和Lp (a) 测试的指导方针已经发展,在专家委员会之间显示了一些差异.
研究的目的:
- 估计2019年在美国接受了脂质面板任何组件或ApoB和/或Lp测试的受保人人数.
- 评估美国保险成年人中脂质检测和特定生物标志物检测的流行情况.
主要方法:
- 对四个美国索赔数据来源 (医疗补助,医疗保险,商业保险) 进行了横截面分析.
- 流行率估计根据年龄,性别,支付人和地区标准化,以2019年美国人口.
- 对Optum索赔数据库的队列分析描述了2019年至2021年期间接受脂质检测的患者的临床概况.
主要成果:
- 2019年,38%的美国保险成年人至少接受了脂质面板测试的一个组成部分.
- 脂质面板的测试率在65岁以上的成年人中 (62%) 与年轻的成年人 (31%) 相比显著更高.
- 对ApoB和/或Lp的测试 (a) 在所有脂质面板测试中占不到1%;测试随着年龄和并发症的增加而增加.
结论:
- 尽管在心脏病风险评估中具有重要意义,但美国保险成年人中对ApoB和Lp (a) 测试的接受率仍然很低.
- 发布指南的机构应该考虑开展教育活动,以促进超越标准脂质面板测试的更频繁使用.
- 增加ApoB和Lp (a) 测试的使用是有必要的,以改善心血管风险分层和管理.
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