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临床实践中的脂蛋白:风险分层和治疗策略

Nadim Nasrallah¹, Mark Atallah¹, Tarek Harb¹

¹Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

European journal of clinical investigation

|October 4, 2025

概括

脂蛋白 (Lp) 是心血管疾病的关键遗传风险因素. 虽然目前的治疗方法不能降低Lp(a),但新的治疗方法有望降低ASCVD风险.

科学领域:

心脏病学心脏病学
遗传学是一个遗传学.
药理学药理学是指药理学的学科.

背景情况:

脂蛋白 (Lp) 是动脉样硬化心血管疾病 (ASCVD) 的遗传决定性因果风险因素.
Lp(a) 水平是稳定的,最好用特定的测量方法测量,并建议在所有成年人中进行一次性测量.
指导方针建议对Lp升高的家庭进行级联测试.

研究的目的:

审查脂蛋白在心血管疾病中的作用.
讨论目前的指导方针和测量方法Lp.
探索降低Lp (a) 的新兴疗法及其对ASCVD结果的潜在影响.

主要方法:

关于Lp (a) 和心血管疾病的研究的文献综述.
对目前的临床指导方针进行Lp测试和管理的分析.
从新型Lp降低剂的第二阶段试验中得出的结论的摘要.

主要成果:

升高的Lp (a) 与冠状动脉疾病,心肌梗塞和大动脉狭窄的风险增加有关.
高Lp (a) 与缺血性中风和脑血管疾病的不良结果有关.
对于升高的Lp (a) 水平 (≥50 mg/dL或≥125 nmol/L) 建议加强风险因素的修改.

结论:

目前没有一种降脂疗法能够显著降低Lp (a) 水平.
像ASOs,siRNAs和小分子这样的新型药物在第二阶段试验中显示出希望.
第三阶段试验正在评估Lp(a) 在ASCVD的因果作用以及降低Lp(a) 降低心血管事件的有效性.

关键词:

这是一个ASCVD.急性冠状动脉综合征是什么大动脉狭窄症 (大动脉狭窄症)预防心血管疾病和预防心血管疾病脂蛋白 (a) 是一种蛋白质风险分层的风险分层.

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