根据遗传风险进行心房动查:随机LOOP研究的二次分析
Oliver B Vad1, Søren Z Diederichsen2, Lucas Y Xing2
1Department of Cardiology, the Heart Centre, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark; Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.
Journal of the American College of Cardiology
|October 29, 2025
概括
多遗传风险评分 (PRS) 可以识别受益于心房动 (AF) 查的个人. 植入式循环记录器 (ILR) 查减少了高PRS-AF,但不低PRS-AF的中风/全身血栓塞 (SE).
科学领域:
- 心血管医学 心血管医学
- 遗传学 是一个遗传学.
- 预防性心脏病学 预防性心脏病学
背景情况:
- 多基因风险评分 (PRS) 是用于心血管疾病风险分层的新兴工具.
- 前庭动 (AF) 查旨在预防中风和全身栓塞 (SE).
研究的目的:
- 评估AF查使用植入式循环记录器 (ILR) 预防中风的有效性,与AF的多基因风险评分 (PRS_AF) 相比.
主要方法:
- 随机LOOP研究的后期分析包括5656名AF-naive个体 (≥70岁) 具有中风风险因素.
- 参与者被随机分配到ILR查或通常的护理.
- 特定原因的考克斯回归评估了ILR查和PRS_AF之间对中风/SE和重大出血的相互作用.
主要成果:
- 较高的PRS_AF与增加的AF率有关 (HR: 1.20).
- 在PRS_AF≥中位数 (HR:0.65) 个体中,ILR查显著减少了中风/SE,但在PRS_AF<中位数 (HR:1.06) 个体中并没有显著减少.
- 在PRS_AF<中位数 (HR: 1.71) 的患者中,ILR查增加了重大出血风险.
结论:
- 在具有高遗传倾向 (高PRS_AF) 的个体中,通过ILR进行AF查有效减少了中风/SE.
- 这些发现表明,PRS可能有助于个性化AF查策略,以实现最佳的中风预防.
相关概念视频
Acute Coronary Syndrome III: Diagnostic Studies
190
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
190
Coronary Artery Disease IV: Preventive Measures
563
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...
563
Dysrhythmias V: Evaluating Dysrhythmias
277
Dysrhythmias, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...
277
Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
358
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...
358


