优化长期心血管风险分层:将生物标志物整合到亚洲患者的非常高风险ASCVD定义中

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Jiaxi Cheng^1,2,3,4, Hao-Yu Wang^1,2,3,4, Chenxi Song^1,2,3,4

¹Cardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

American journal of preventive cardiology

|April 11, 2025

概括

非常高风险 (VHR) 定义有效地识别了患有动脉样硬化心血管疾病 (ASCVD) 的亚洲患者. 将生物标志物纳入非常非常高风险 (VVHR) 类别进一步完善了密集治疗的分层.

科学领域:

心脏病学心脏病学
预防医学预防医学
生物标志物研究生物标志物研究

背景情况:

2018年AHA/ACC胆固醇指南定义了非常高风险 (VHR) 动脉样硬化心血管疾病 (ASCVD) 患者,以指导密集的降脂疗法.
在亚洲人口中评估VHR定义的有效性对于准确的心血管 (CV) 风险评估至关重要.

研究的目的:

评估VHR定义在亚洲人口中对心血管风险分层的有效性.
检查其他生物标志物的预测价值,以提高ASCVD患者的风险分层.

主要方法:

福井医院有望招收26752名ASCVD患者 (2017-2018年).
VHR定义:多个主要的ASCVD事件或一个主要的事件与多个高风险条件.
主要结局:三年内心血管事件的组合 (死亡率,心脏病发作,中风,再血管化).

主要成果:

与非VHR患者 (7.3%) 相比,VHR患者 (54.1%) 的三年事件率 (9.6%) 较高.
血红蛋白 (Hb),hs-CRP,Lp(a) 和HDL-C显著影响了VHR患者的心血管风险.
非常非常高风险 (VVHR) 类别 (≥2个异常生物标志物) 的事件发生率 (11.7%) 比异常生物标志物较少 (8.9%) 的事件发生率更高.

结论:

在VHR定义有效地识别高风险的亚洲ASCVD患者.
整合基于生物标志物的高风险状况完善了VHR分层.
拟议的VVHR类别增强了密集降脂和残留风险管理的风险分层.

关键词:

动脉样硬化心血管疾病.生物标志物生物标志物心血管风险分层的分层.降脂疗法是一种降脂疗法.非常高风险非常高风险

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