炎症驱动疾病中的心血管风险分层:我们走了多远?
Gustavo L R Silva1, Andrei C Sposito1, Otavio Coelho-Filho1
1Discipline of Cardiology, Department of Medicine, Faculty of Medical Science, State University of Campinas, Campinas, Brazil.
Frontiers in cardiovascular medicine
|February 12, 2026
概括
炎症显著增加心血管风险,即使没有传统因素. 纳入炎症生物标志物可以改善风险评估,特别是在中等风险患者和二次预防中,当前的方法不足.
科学领域:
- 心脏病学 心脏病学
- 炎症研究 炎症研究
- 预防医学 预防医学
背景情况:
- 传统的动脉样硬化心血管疾病 (ASCVD) 风险分层依赖于高血压和糖尿病等因素.
- 这些传统因素往往无法捕捉ASCVD贡献者的全部复杂性.
- 炎症在动脉样硬化斑块的发展和不稳定性中起着关键作用,但在风险评估中未得到充分利用.
研究的目的:
- 对将炎症生物标志物纳入ASCVD风险分层的研究进行审查.
- 评估炎症标志物在初级和二级预防中的有效性.
- 探索心血管事件传统风险评估的替代方案.
主要方法:
- 在PubMed和Open Evidence平台上进行系统的文献搜索.
- 关键词包括"心血管","风险分层"",炎症",以及"初级预防"或"残留风险"等术语.
- 分析了25项研究 (1项元分析,15个队列,9个横截面) 和支持性文献.
主要成果:
- 炎症状况使心血管死亡风险增加24%至近三倍,独立于传统的风险因素.
- 传统的风险评分对50%以上的中等风险个体进行了错误分类.
- 在二次预防中,高高灵敏度C反应蛋白与较高的死亡率和不良事件有关.
结论:
- 炎症生物标志物为ASCVD风险分层提供了更全面的方法.
- 整合炎症评估对于改善初级和二级预防策略至关重要.
- 目前的风险分层工具需要加强,以解决炎症对心血管事件的影响.
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