脂蛋白和冠状动脉疾病:普遍查的必要性 - 一个基于案例的审查
Nguyen Yen Nhi Ngo1, Chloé Davidson Villavaso1, Chisom Joan Orakwue1
1Tulane School of Medicine, 1430 Tulane Ave, New Orleans, LA 70112, United States of America.
概括
升高的脂蛋白 (Lp) 是动脉样硬化心血管疾病 (ASCVD) 的独立危险因素. 这一案例表明Lp测试对于准确的ASCVD风险评估至关重要,特别是在年轻女性中.
科学领域:
- 心脏病学 心脏病学
- 预防医学 预防医学
- 遗传学 是一个遗传学.
背景情况:
- 动脉样硬化心血管疾病 (ASCVD) 是全球主要的死亡原因.
- 已确定的ASCVD风险因素是众所周知的,但风险可能被低估.
- 脂蛋白 (Lp) 越来越被认为是一个独立的ASCVD风险因素.
研究的目的:
- 在有低计算ASCVD风险的绝经前妇女中呈现严重冠状动脉疾病 (CAD) 病例.
- 为了突出低估了心血管风险,由于不充分评估Lp.
- 倡导对升高的Lp的普遍查.
主要方法:
- 一个44岁的绝经前女性的病例报告,胸部不适.
- 诊断工作包括ASCVD风险因素的评估和冠状动脉血管学.
- 审查当前的指导方针和文学关于Lp(a) 和ASCVD风险.
主要成果:
- 患者,尽管计算的10年ASCVD风险很低,高血压得到控制,但被发现患有严重的,化的左前下降动脉狭窄.
- 较高的Lp (a) 水平被确定为一个显著的促成因素.
- 当前的指导方针 (2018年ACC/AHA) 将Lp (a) 归类为风险增强因子,而不是主要风险因子,导致诊断不足.
结论:
- 对Lp (a) 的不充分评估可能导致低估ASCVD风险.
- 根据最近的国际科学声明,建议对升高的Lp (a) 进行普遍查.
- 针对Lp (a) 减少的未来疗法可能会改善患者在ASCVD预防方面的结果.
更多相关视频
06:57Author Spotlight: Advancing Cardiovascular Imaging - Introducing the Spatially Weighted Calcium Score for Early Disease Detection
Published on: September 22, 2023
1.1K
10:03Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
5.4K
相关概念视频
01:26Coronary Artery Disease IV: Preventive Measures
39
Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
39
01:27Coronary Artery Disease V: Interprofessional Care
39
Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
39
01:30Coronary Artery Disease I: Introduction
69
Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
69
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
129
Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
129
01:26Atherosclerosis III: Management
42
Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
42
01:27Atherosclerosis II: Clinical Manifestations and Diagnostic Tests
42
Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...
42