低密度脂蛋白胆固醇在目标范围中的时间和一般人群中的临床结果
Jiale Huang1, Zhongping Yu1, Yuzhong Wu1
1Department of Cardiology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
JACC. Advances
|September 19, 2025
概括
保持低密度脂蛋白胆固醇 (LDL-C) 在目标范围内 (TTR) 与心脏病发作,心血管疾病,心力衰竭和中风风险降低有关. 更高的LDL-C TTR显著改善了心血管风险预测.
科学领域:
- 心脏病学 心脏病学
- 预防医学 预防医学
- 公共卫生 公共卫生
背景情况:
- 低密度脂蛋白胆固醇 (LDL-C) 是心血管风险的关键预测因素.
- 目标范围内的LDL-C时间 (TTR) 对临床结果的影响尚未完全理解.
研究的目的:
- 检查LDL-C TTR与一般人群中不良临床结果之间的关联.
- 为了确定LDL-C TTR是否可以改善心血管风险预测模型.
主要方法:
- 分析了8,813名社区动脉样硬化风险 (ARIC) 研究参与者,其中至少有两次LDL-C测量.
- 根据患有或没有患有心血管疾病 (CVD) 的参与者的目标水平 (<70 mg/dL或<130 mg/dL) 计算的LDL-C TTR.
- 多变量考克斯模型,竞争性风险分析和里程碑分析用于评估与心肌梗塞 (MI),心血管疾病,心力衰竭 (HF) 和中风的关联.
主要成果:
- 较高的LDL-C TTR (75%-100%) 与较低的TTR组 (0%-25%) 相比,与显着降低心脏病 (33.2%),心脏病 (33.8%),高血压 (15.3%) 和中风 (23.7%) 的风险有关.
- 将LDL-C TTR纳入常规风险模型大大改善了对MI和CVD风险的预测.
- 通过C统计证实了统计学意义,净重新分类改进和综合歧视改进.
结论:
- 在一般人群中,较高的LDL-C TTR与较低的重大心血管不良事件风险显著相关.
- LDL-C TTR是提高心血管风险分层的一个有价值的指标.
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