极端脂蛋白 (a) 是与异构性家族性高胆固醇血症等同的心血管风险
Martine Paquette1, Bertrand Cariou2, Simon-Pierre Guay3
1Lipids, Nutrition, and Cardiovascular Prevention Clinic of the Montreal Clinical Research Institute, Montreal, Québec, Canada (Paquette, Drs Guay, and Baass).
Journal of clinical lipidology
|September 12, 2025
概括
在家族性高胆固醇血症 (FH) 患者中,高脂蛋白 (Lp) 水平表明极端的心血管风险. 积极的治疗对于这些人来说至关重要,以预防动脉样硬化心血管疾病 (ASCVD).
科学领域:
- 心脏病学 心脏病学
- 遗传学 是一个遗传学.
- 脂质学 脂质学是指脂质学.
背景情况:
- 家庭性高胆固醇血症 (FH) 和高脂蛋白[Lp]是单一的疾病,增加了动脉样硬化心血管疾病 (ASCVD) 的风险.
- 确定高Lp (a) 值有助于对异合性FH (HeFH) 患者的风险分层.
研究的目的:
- 确定与接受初级预防的HEFH患者10年ASCVD风险相当于心血管风险的Lp (a) 水平.
主要方法:
- 采用来自法国,英国和加拿大的前性数据进行的多国观测研究.
- 包括2979名成年HeFH患者在初级预防中和10,521名非FH对照在二级预防中.
- 使用Kaplan-Meier估计和Cox回归模型评估了10年ASCVD风险.
主要成果:
- 在初级预防HeFH患者中,Lp (a) 的第90百分位是≥100 mg/dL (≥250 nmol/L).
- 10年ASCVD风险为28.7%的HFH患者的Lp (a) ≥100 mg/dL,而Lp (a) <100 mg/dL的患者的风险为11.0%.
- 这与二次预防中非FH个体的10年ASCVD风险为34.9%形成鲜明对比.
结论:
- 在初级预防中,大约10%的HEFH患者由于双重单一性脂质失调症而表现出极端的心血管风险.
- 这些人需要更积极的ASCVD预防策略.
- 新型Lp (a) 向疗法可以为这一高风险群体提供显著的益处.
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