脂蛋白和动脉样硬化负担 - 在采取行动之前,我们是否应该等待临床试验证据?
Isabella Fichtner1, Chiara Macchi1, Alessandra Stefania Rizzuto2
1Department of Pharmacological and Biomolecular Sciences "Rodolfo Paoletti", Università Degli Studi Di Milano, Milan, Italy.
Atherosclerosis plus
|October 22, 2024
概括
脂蛋白是动脉样硬化心血管疾病 (ASCVD) 的因果风险因素. 测量脂蛋白 (a) 水平有助于识别未来向治疗的高风险个体.
科学领域:
- 心脏病学 心脏病学
- 遗传学 遗传学 是一个
- 流行病学 流行病学
背景情况:
- 脂蛋白 (a) 越来越被认为是动脉样硬化心血管疾病 (ASCVD) 的重要独立风险因素.
- 升高的脂蛋白 (a) 水平会导致剩余的心血管风险,即使其他风险因素得到控制.
- 了解脂蛋白的因果作用对于完善心血管风险评估和管理策略至关重要.
研究的目的:
- 审查目前支持脂蛋白和ASCVD之间的因果关系的证据.
- 在等待临床试验结果之前,讨论降低脂蛋白水平的潜在策略.
- 突出测量脂蛋白的临床实用性 (a) 对于风险分层.
主要方法:
- 系统审查流行病学和遗传学研究.
- 对发生ASCVD时脂蛋白的预测值的数据分析.
- 对当前脂蛋白测量指南和建议的评估.
主要成果:
- 强大的流行病学和遗传学数据证实了脂蛋白升高和ASCVD风险增加之间的因果关系.
- 脂蛋白 (a) 水平在整个人口分布中显示出线性风险梯度.
- 脂蛋白 (a) 在初级和二级预防环境中预测ASCVD事件.
结论:
- 脂蛋白应该被认为是ASCVD的因果风险因素.
- 测量脂蛋白 (a) 水平对于识别可能从未来的脂蛋白 (a) 降低疗法中受益的人来说是有价值的.
- 国家协会建议在高风险个体和一般风险分层中测量脂蛋白.
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