血脂蛋白升高个体的一级亲属的主要心血管事件:基于登记的队列研究
Gustav Kindborg1, Daniel Eriksson Hogling1, Henrike Häbel2
1Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.
European heart journal
|August 31, 2025
概括
高脂蛋白 (Lp) 的第一级亲属面临心血管疾病的风险增加. 连续查可以识别这些有风险的亲属,以便及早介入.
科学领域:
- 心血管科学
- 遗传学
- 流行病学
背景情况:
- 脂蛋白 (a) [Lp (a)) 是由基因决定的,并且与动脉样硬化心血管疾病有因果关系.
- 患有升高Lp (a) (≥80百分位) 的人的第一级亲属 (FDR) 的心血管风险尚不清楚.
研究的目的:
- 调查父母的高脂蛋白水平与第一级亲属发生重大心血管不良事件 (MACE) 的风险之间的关联.
- 评估Lp (a) 水平在家庭中的一致性.
主要方法:
- 使用了瑞典STRIREG队列,其中包括41,304名指数个体和61,715名FDR (年龄在35-69岁之间).
- 基于指数Lp (a) 百分位 (<第50位,第50位,第80位,第80位,第95位,≥95位) 的分层FDR,并使用相应风险调整的累计发病率和Cox回归来分析MACE发病率.
- 在对4243个相关指数个体的嵌套分析中检查了Lp (a) 的一致性.
主要成果:
- 在平均19年的随访期内,患有升高Lp (a) 的个体的FDR呈现出MACE风险的逐渐增加.
- 在65岁时,MACE的累积发病率随着父母的Lp (a) 层增加 (6. 2%至8. 1%,P< 0. 001).
- 随着父母的Lp (a) 层较高,MACE的危险比率显著增加 (例如,80-<95百分位数的1. 30).
结论:
- 患有升高Lp的患者的第一级亲属有较高的重大心血管不良事件发生率.
- 随序查FDR是一种潜在的有效策略,用于识别因遗传性高Lp (a) 导致心血管风险增加的个体.
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