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通过确定脂蛋白 (a) 水平来重新分类低或中等心血管风险

Alberto Cordero^1,2,3, José Ma Salinas⁴, María Amparo Quintanilla¹

¹Cardiology Department, Hospital Universitario de San Juan, 03550 Alicante, Spain.

|November 27, 2025

概括

脂蛋白 (a) [Lp (a) ]测试在最初被评估为低风险或中等风险的个体中确定了显著的心血管风险. 这种测试还确定了对他类药物治疗的资格,改善了心血管疾病预防策略.

科学领域:

心脏病学心脏病学
预防医学预防医学
临床生物化学临床生物化学

背景情况:

脂蛋白 (Lp) 是已知的心血管疾病的独立风险因素.
对于全面的心血管风险评估,建议对Lp (a) 水平进行终身测定.
当前的风险分层模型可能无法完全捕捉与Lp (a) ]相关的风险.

研究的目的:

评估脂质蛋白 (Lp) 测试对心血管风险重新分类的影响.
根据低至中等风险队列中的Lp (a) 水平来评估对他类药物治疗的资格.
将Lp(a) 测量纳入现有的心血管风险预测工具,如SCORE2.

主要方法:

患有低或中等心血管风险的受试者 (SCORE2) 接受了Lp (a) 测定.
患有Lp (a) >50 mg/dL的个体被归类为风险较高的人.
根据已确定的治疗目标和Lp(a) 结果评估了类固醇药物的适用性.

主要成果:

22.1%的队列表现出Lp (a) 水平>50 mg/dL,表明心血管风险较高.
纳入Lp (a) 的风险从低风险转为中等风险的比例为22.6%,从中等风险转为高风险的比例为77.4%.
61.4%的受试者在Lp (a) 测试后有资格接受他类药物治疗.

结论:

脂蛋白 (a) [Lp (a) ]测试显著重新分类了大量最初被认为是低风险或中等风险的个人的心血管风险.
常规Lp(a) 测量确定了高比例的患者有资格接受他类药物治疗,增强了预防性心脏病治疗策略.
将Lp(a) 整合到SCORE2等风险得分中,可以提高心血管风险分层的准确性,并指导治疗决策.

关键词:

脂蛋白 (a) 是一种蛋白质重新分类的重新分类是什么危险的风险危险的风险

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