在动脉样硬化心血管疾病事件中,CACS和Lp之间的性别特异性预后差异:MESA研究

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Ruijia Xue¹, Jiali Liu^2,3, Haoyang Wang⁴

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|November 6, 2025

概括

脂蛋白和冠状动脉分数独立预测心血管风险. 它们的预测值在性别之间存在差异,特别是在特定的冠状动脉分数类别中,为性别特定的预防策略提供信息.

科学领域:

心脏病学心脏病学
预防医学预防医学
生物标志物生物标志物

背景情况:

脂蛋白[Lp]和冠状动脉分数 (CACS) 是动脉样硬化心血管疾病 (ASCVD) 风险的独立预测因素.
了解Lp(a) 和CACS预后价值的潜在性别差异对于完善ASCVD风险评估至关重要.

研究的目的:

在预测ASCVD风险时,研究Lp(a) 和CACS之间的性别特异性预后差异.
为了比较Lp(a) 和CACS在男性和女性中的预测性能.

主要方法:

从多民族动脉样硬化研究中对4651名参与者的分析,按性别分层.
多变量考克斯回归分析以评估Lp(a) 和CACS对ASCVD风险的预后值.
使用C指数分析对预测性能的比较.

主要成果:

两个升高的Lp(a) 和CACS都是ASCVD风险的独立预测者,在中位数随访13.84年期间,男女均有ASCVD风险.
在男性 (P=0.011) 中,CACS提供了超过Lp (a) 的增量预后值,但在女性 (P=0.069) 中没有.
在CACS>400的男性和CACS>100的女性中,升高的Lp (a) 与更高的ASCVD风险有关.

结论:

虽然Lp(a) 和CACS独立地预测ASCVD风险,但Lp(a) 的预测值在不同CACS类别的性别之间存在显著差异.
研究结果表明,在ASCVD的初级预防中需要针对性别的具体策略,同时考虑Lp(a) 和CACS水平.

关键词:

动脉样硬化动脉样硬化和是最重要的.心血管疾病心血管疾病首要预防首要预防回归分析是一种回归分析.

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